Mr. editor

The epidemiological transition that the world is experiencing requires health personnel prepared to respond to the needs and demands of the population; This also applies to low-income and medium-income countries, where oncological and non-oncological diseases are diagnosed in advanced stages and represent a high burden for the patient and family, often associated with pain and suffering.^1,2.

Palliative care (PC) aims to alleviate suffering, constitutes a fundamental human right and must be provided with the best possible quality¹. The physician's competencies must be adapted to the needs of the population; however, in Latin America, there are few specific training programs on palliative care, and they are even more scarce or absent in undergraduate programs³. For more than a decade, measures have been proposed to improve this; In countries such as Brazil, Argentina, Costa Rica, Colombia, and Chile, meetings on education and PC have been held where experts recommend starting from undergraduate university studies to acquire basic communication skills, apply bioethical principles, learn PC principles, comprehensively understand the patient and his family, and recognize the importance of teamwork⁴.

In 2020, the Latin American Atlas of PC reported that only 15% of medical schools in the region had an independent subject on PC⁵. In 2021, the knowledge about it among Peruvian medical students was reported as low or intermediate⁶; nevertheless, there are reports of educational experiences with clear benefits in other parts of the world^7,8. Although it is actual PC are taught as chapters, within some courses of the professional medical career, in Peru in 2019, formal postgraduate educational programs in PC began (with the first master's degree at a public university). In the first semester of 2022, At the same university, the first exclusive undergraduate course on PC was opened for students in the ninth semester of medicine, in virtual mode (in the context of the COVID-19 pandemic), with a capacity for 40 students (a quarter of the promotion) of 16 weeks duration and voluntary participation at the choice of the students.

The students mentioned that the main reason for choosing the course was facing advanced illnesses, in the family environment, with suffering and the need for palliative care, which was often not recognized as such.

95% of the students expressed a satisfactory opinion with the development of the course (figure 1) and showed interest in the subject, active participation, and achieved good grades; highlighted the humanistic, biopsychosocial and spiritual approach, as well as addressing issues that are not covered in other courses: the approach to the end of life and coping with death, as well as communication strategies and interaction with the family of the patient in need of PC. All students mentioned that they would recommend the course to their peers, and 93% believe that it should be required for all medical students. Among the aspects to be improved, they mentioned the need for face-to-face activities and the opportunity to learn about real clinical cases.

We consider this an excellent step for medical training in the country, where the PC culture is in the development phase, and it will be expanded to all students of medicine and health sciences, which will contribute to improving the quality of life of the patient and that of his family; Likewise, the humanization of medicine will be favored, which is the great society demand^9,10.

Figure 1. Grade of satisfaction with the first palliative care course in undergraduate medicine at a Peruvian public university. Survey conducted at the end of the course, response rate 78%, average age 23 years (20-28), female 48%.