End-of-life and palliative care education for final-year medical students: a comparison of Britain and the United States.

PURPOSE: (1) To assess British medical students' experiences and education in palliative care. (2) To compare experiences and education in palliative care between medical students in Britain and the United States.
METHOD: Using a self-administered questionnaire adapted from an earlier U.S. study, British students were surveyed on the quantity and quality of palliative care education, training in specific end-of-life topics, preparation to provide end-of-life care, exposure to palliative care role models, attitudes, and culture.
RESULTS: Four hundred forty-five final-year students from four British medical schools (response rate 97% in sampled schools, or 12% of British final-year students in 2003) were compared to 1455 students from 62 U.S. schools (overall response rate 62%, or 9% of U.S. final-year students in 2001). Compared to U.S. students, British medical students reported more training in palliative care, more positive clinical encounters in palliative care, greater educational training in specific end-of-life topics, greater preparedness for caring for patients at the end of life, a culture within medicine more favorable toward palliative care, and attitudes more consistent with support for palliative care (all at statistically significant levels of p < 0.0001).
CONCLUSIONS: Palliative care education, from the perspective of medical students, appears to be more effective in Britain than in the United States. Our findings suggest three changes with the potential to improve U.S. palliative care education of medical students: increasing required course-work in palliative care, increasing the number of palliative medicine role models, and creating robust academic palliative medicine departments to lead and support these advances.