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Students entering medical school today will encounter an ageing population and a higher incidence of patients with terminal and life threatening illness. This study was carried out to determine the attitudes of pre-clinical medical students towards the care of patients for whom a cure is not possible. All students were invited to complete a 23-item questionnaire prior to any teaching in palliative care. Of the 186 students who participated in the study, 151 (79%) completed the pre-teaching questionnaire (males=59; females 90; median age 20 years; range 19?27]. Attitudes towards chronically ill and dying patients were generally positive. When comparing age with attitudes it was found that increasing age was associated with a more positive view of caring for patients with chronic or terminal illness, a more positive view of listening to patients reminisce and a more positive view of patients dying at home. Caring for patients at the end of life can be one of the most rewarding aspects of being a doctor. This study suggests that the majority of medical students have a positive attitude towards patients with chronic and terminal illness?the trend for encouraging older students to enter medicine may be an influencing factor. [ABSTRACT FROM AUTHOR]

Background. Palliative care research highlights depression as a common, treatable condition in patients with terminal cancer. Guidance from the European Association for Palliative Care calls for proactive screening and treatment of the disease. However, prevalence of depression among primary care patients with advanced cancer is unknown and it remains uncertain whether existing guidance is appropriate for use by GPs. Objective. To estimate the prevalence of depression in a primary care population with terminal cancer. Methods. A two-stage community prevalence survey conducted in primary care practices in Merseyside, UK. Adult patients with advanced metastatic cancer were invited to join the study. In phase 1, a depression screening tool (the Edinburgh Depression Scale [EDS]) was used to categorize patients as being high or low risk of depression. In phase 2, samples from each group underwent a diagnostic assessment using the revised Clinical Interview Schedule. Weighted prevalence estimates were calculated. Results. In a final sample of 70 (response rate 47.9%), the prevalence of depression was 4.1% (95% confidence interval 0–8.8%). The sensitivity and specificity of the EDS were poorer than predicted. Conclusion. The prevalence of depression in our sample was lower than expected given findings from previous studies. Screening tools also performed differently in this population. The limitations in our study are discussed; however, our findings raise questions about whether depression guidance from palliative care studies can be directly applied to a primary care setting. We propose the need for development of a primary palliative care evidence base to underpin appropriate clinical care. [ABSTRACT FROM AUTHOR]