Junior Consultant – Palliative Care at African Medical Centre of Excellence (AMCE)

Job Objective

• The Junior Consultant, Palliative Care will be responsible for providing expert, compassionate, and evidence-based palliative care to patients with cancer and haematological disorders.
• The role holder will lead complex symptom management, advance care planning, and end-of-life care, while supervising junior medical staff, driving quality improvement, and contributing to service development.

Key Accountabilities / Responsibilities

Advanced Patient Care and Complex Symptom Management:

• Lead the clinical assessment and management of patients with complex, refractory symptoms (pain, dyspnoea, nausea, delirium, malignant obstruction) using advanced pharmacological and interventional techniques.
• Independently develop, implement, and review individualized palliative care plans for patients with advanced cancer and haematological malignancies, ensuring alignment with patient goals and evidence-based guidelines.
• Prescribe, titrate, and monitor opioids, adjuvants, and palliative sedation protocols in compliance with institutional and national regulations.
• Conduct daily structured ward rounds for palliative care inpatients, ensuring timely escalation and de-escalation of care.
• Lead rapid response consultations for palliative emergencies (e.g., spinal cord compression, hypercalcaemia, massive bleeding).
• Document all clinical decisions, medication changes, and patient/family discussions within 24 hours, maintaining medico-legal standards.

Leadership and Supervision of Multidisciplinary Team (MDT):

• Supervise and clinically mentor Palliative Care Specialists (Senior Registrars), junior medical officers, and rotating residents in day-to-day palliative care delivery.
• Chair weekly MDT case conferences with oncology, haematology, pain team, psychology, pharmacy, nursing, and spiritual care to coordinate patient-centred care.
• Delegate tasks appropriately to junior staff while retaining accountability for patient outcomes.
• Conduct bedside teaching and case-based learning sessions for the palliative care team at least twice weekly.
• Facilitate collaborative decision-making between palliative care and primary oncology/haematology teams to avoid fragmented care.
• Review and co-sign clinical notes, discharge summaries, and care plans prepared by junior staff within 48 hours.

End-of-Life Care, Advance Care Planning, and Ethical Decision-Making:

• Lead advance care planning discussions with patients and families, documenting advance directives, ceilings of treatment, and Do Not Attempt Resuscitation (DNAR) orders.
• Manage complex ethical dilemmas including requests for futile treatment, voluntary refusal of nutrition/hydration, and palliative sedation to unconsciousness.
• Provide compassionate terminal care, including management of terminal agitation, secretions, and family support in the final 48 hours of life.
• Facilitate family meetings for high-conflict or emotionally complex cases, ensuring shared understanding and documented decisions.
• Coordinate with legal, risk management, and clinical ethics committees for cases requiring formal review.
• Supervise bereavement follow-up processes, ensuring at least one structured contact with families post-death.

Patient, Family, and Caregiver Education & Psychosocial Support:

• Lead comprehensive education sessions for patients and families on disease trajectory, palliative care philosophy, symptom management, and practical caregiving at home.
• Address cultural, spiritual, and existential concerns by integrating psychosocial and chaplaincy support into care plans.
• Empower patients and families to participate in shared decision-making using decision aids and plain-language communication.
• Develop and review written and multimedia educational materials tailored to local language and literacy levels.
• Provide emotional support and coping strategies for families facing anticipatory grief, caregiver burden, and post-death bereavement.
• Train caregivers in safe medication administration (e.g., subcutaneous opioids), recognition of deteriorating signs, and when to seek emergency help.

Governance, Documentation, and Quality Assurance:

• Ensure 100% compliance with institutional policies, MDCN guidelines, and international palliative care standards in all clinical documentation.
• Lead monthly palliative care documentation audits, providing feedback and corrective action plans to junior staff.
• Participate in hospital-wide mortality and morbidity meetings, presenting palliative cases with learning points.
• Contribute to the development, review, and implementation of palliative care protocols, order sets, and clinical pathways.
• Ensure accurate coding, data entry, and reporting for  hospital quality dashboards and national palliative care registries.
• Report adverse events, medication errors, and near misses within 24 hours, leading root cause analysis when indicated.

Research, Education, and Continuous Quality Improvement (CQI):

• Design and lead at least one clinical audit or quality improvement project annually (e.g., reducing opioid prescription errors, improving pain reassessment rates).
• Supervise junior staff in conducting case series, literature reviews, and poster presentations for internal or external conferences.
• Identify gaps in service delivery (e.g., delayed referrals, poor community transition) and propose evidence-based service innovations.
• Participate in institutional research ethics committee submissions and data collection for ongoing studies.
• Stay current with published literature and integrate new evidence (e.g., ketamine for cancer pain, cannabinoids) into practice after critical appraisal.

Qualifications

Education, Skills and Competencies:

• Medical Degree & Residency Completion – MBBS, MBChB, or equivalent from a recognised institution, with completion of residency in Internal Medicine, Family Medicine, Oncology, or Palliative Medicine.
• Licensure, Fellowship & Professional Membership – Valid medical license; Fellowship or Membership in Palliative Medicine, Oncology, or Internal Medicine.
• Fellowship of 1 – 3 year post fellowship experience
• Completion of a recognised diploma or certificate in Palliative Care or Hospice Medicine.
• Experience in advanced cancer and haematological disorder management, including end-of-life care, advance care planning, symptom management, palliative emergencies, and opioid prescribing/titration.
• Experience in MDT collaboration, supervision of junior medical staff, and working with patients and families in crisis or distress.
• Strong knowledge of palliative care principles, pain relief strategies, palliative sedation protocols, oncology/ haematology disease trajectories, prognostication, and ethical/ legal aspects.
• Excellent communication and leadership (breaking bad news, family meetings, conflict resolution, bedside teaching); competence in clinical audits, QI projects, and evidence-based practice; cultural competence and emotional resilience.

Must have skills:

• Invasive Procedures.
• Non-Invasive Procedures.