Palliative medicine specialization in Latin America: A comparative analysis

Abstract Background Formal recognition of palliative medicine as a specialty has been one of the main drivers in the development of palliative care. Aim To provide a comparative, comprehensive overview on the status of palliative medicine as medical specialty across Latin America. Method We conducted a comparative study of 19 Latin American countries. Key informants and persons in charge of the specialization training programs were identified and interviewed. We collected data on general recognition as specialty (title, process of certification) and on training program characteristics (title, start year, requirements, training length and type full time or part time). Results Eight of 19 countries (42 %) Argentina, Brazil, Colombia, Costa Rica, Ecuador, Mexico, Paraguay and Venezuela reported palliative medicine as medical specialty. Thirty-five (sub)specialization training programs in palliative medicine were identified in the region (8 as a specialty and 27 as a subspecialty), the majority in Colombia (43.5%) and Brazil (33.7%). 20% of the programs have yet to graduate their first cohort. Length of clinical training as specialty varied from two to four years, and from 520 hrs. to three years for a subspecialty. Conclusion Despite long-standing efforts to improve quality of care, and significant achievements to date, most Latin American countries have yet to develop palliative medicine as medical specialty. Specialty and sub-specialty training programs remain scarce in relation to regional needs, and the programs that do exist vary widely in duration, structure, and content.