Today palliative care represents a reference standard of care for patients with advanced chronic illnesses and for their families. This field of knowledge comes from the increasing ageing of the population and the corresponding change in patterns of mortality and morbility, as well as a societal context of increasing individualisation of family ties, but also as a reaction to an increase in suffering in vulnerable populations, through abandonment or through therapeutic obstinacy in a society that is increasingly technology-based.

Palliative care has progressively been implanted over the last decade into the clinical area, into research, into teaching and into society.
The Faculty of Medicine of the University of Lisbon (FMUL), after organising the first post-graduate courses (2000 and 2001), created the first Masters course in palliative care in Portugal (2002-2003), with its 7th edition being held at the moment.

The FMUL has in this way contributed towards professionalising post-graduate training (about 200 health professionals) and towards the development of scientific research in this field.

It has also developed a post-graduate course in blended-learning, which has trained 184 health professionals in the Regional Health Administrations (ARS) of the Alentejo, the Algarve, the North and the Autonomous Region of the Azores.

We are pleased to have seen many of our Masters and students in palliative care taking on the creation and development of palliative care teams/units throughout the country, as well as setting up actions for divulging this area of knowledge.

The publication of the Manual of Palliative Care (1st edition in 2006 and 2nd edition revised and significantly increased in 2010) is now a particularly well accepted reference in the professional, scientific and civic world.

From the outset the Masters course has had the collaboration of internationally prestigious universities: University of Sheffield, University of Texas M. D. Anderson Cancer Center, Medical College of Wisconsin Palliative Care Center, University of California, Universitat de Barcelona, Hospital Universitário La Paz – Madrid and Universitat de Vic – Catalonia.

The Masters in Palliative Care aims at:
1. Integrating pertinent updated theoretical and practical information in the field of palliative care;
2. Promoting the capacity to deal with techniques of assessment and with therapies that allow clinical approach in palliative care;
3. Promoting pedagogical skills towards the development of on-the-job palliative care training plans for health professionals;
4. Stimulating the capacity for critical and ethical reflection and of problematising the human and technical subjects that are raised by the exercise of palliative care;
5. Giving methodological preparation that provides the ability to carry out research in health services.

The curricular component of the Masters course includes the following modules:
– Principles and challenges in palliative care;
– Treatment of pain in palliative care;
– Symptomatic Treatment I in palliative care;
– Symptomatic Treatment II in palliative care;
– Communication and psychological aspects;
– Process of mourning: family and professional support;
– Education and training in palliative care;
– Organisation and management of services in palliative care;
– Research in palliative care;
– Research seminars I and II.

The Masters course has been complemented with symposia /courses open to other participants that the Bioethics Centre /Nucleus of Palliative Care has regularly carried out, at least annually:
• 7 Post-graduate Refresher Courses in Palliative Care
• 7 Post-graduate Refresher Courses “Mourning”

From the point of view of research in palliative care, 57 Masters dissertations have been completed, distributed over the following major areas: need assessment (8); instrument validation (6); assessment of symptoms /clinical research (12); quality of life (10); prognosis (2); experience/competence of health professionals (7); carers (6); communication (6); mourning (3); existential problems (6); ethical problems (1).

This work would not have been possible without the collaboration of other colleagues from the Masters Council (Professors Luís Costa and Isabel Monteiro Grillo and Master Isabel Galriça Neto, as a consultant), of the secretariat of the Bioethics Centre/Nucleus of Palliative Care and the support from the Advanced Training Institute and of the Faculty Directors.

António Barbosa (Director of the Centre of Bioethics /Nucleus of Palliative Care, Coordinator of the Masters Council in Palliative Care) cbioetica@fm.ul.pt