Competition · Palliative Medicine ST4
2.3applicants per post in 2025
136 applications for 58 posts · ST3 entry until 2021
- 3.82019
- 2.82020
- 2.42021
- 1.02022

· Palliative and Internal Medicine Registrar, West Midlands
I completed medical school at the University of Leicester and Foundation Training in the South Thames deanery. The following two years involved a mixture of locuming, completion of an MSc, and volunteering in Uganda as a palliative care doctor before returning to the UK to complete core medical training in the West Midlands. I started Palliative Medicine training in 2020 in the West Midlands. Throughout my training, I have continued to volunteer internationally with two Palliative Care charities, teaching and supporting the development of Palliative Care. I work at 80% and work 1 day a week for my local church.
Competition · Palliative Medicine ST4
2.3applicants per post in 2025
136 applications for 58 posts · ST3 entry until 2021
That is down from 3.8 in 2019: applications are up 49% and posts are up 142%.
Source: NHS England Medical Hub — competition ratios, 2019–2025. NHS England had not published a 2026 specialty-level dataset when this was last checked. Checked 14 October 2026.
Consider joining the Association of Palliative Medicine. Not only will it help you keep up to date on what’s going on in the world of Palliative Care, but they also have a junior committee where you can join a role that meets your interests/skills.
Think about opportunities that demonstrate leadership or initiative, and that you can work as part of a team (a big part of palliative care is working as part of a multidisciplinary team!), eg, mess committees, local palliative care interest groups, sports groups, local charities, or social action groups
Working in Palliative Care requires you to be a well-rounded individual who understands the importance of looking after yourself whilst doing an emotionally heavy job. Make sure you have things that bring you life and help you unwind.
You will inevitably be doing some Palliative Care, no matter the job you’re in. Take opportunities to reflect on situations you come across and get to know your local Palliative Care team (they will be really happy to welcome you in for a cuppa!) Consider using taster time to see an aspect of Palliative Care that you may not have had exposure to (community teams or hospice settings).
It is likely that the hospital you are rotating through will have an ethics committee. Palliative Care teams are often involved in these, so take any opportunities to sit in on discussions and then reflect on them.
Take any opportunities to engage in audits or local research opportunities. Preferably lead where you can, and the Palliative Care Congress will be a sensible route to try to get a poster presented.
Take opportunities to understand the referral process to the Palliative Care team and how the local teams triage. Understand what the criteria are for local hospice as opposed to hospital teams.
Again, you will inevitably be doing Palliative Care even when outside the specialty. Make friends with someone from the Palliative Care team and ask them if you can reflect on patients you have cared for with them.
Ask if you can organise for the Palliative Care team to come and do some training with the team you are working with, and offer to join in with the teaching if you feel you can contribute something based on previous experience. A lot of Palliative Care is supporting other teams to do Palliative Care.
Talk to your local Palliative Care team and see if there is a relevant QIP that you could run with your team, eg, anticipatory prescribing, advance care planning, etc.
Palliative Care is a vast speciality, so find the bits you find interesting and tailor your CV towards that. But ultimately, do what you find interesting!! Our working lives are too long to be doing things just for the sake of a CV.
As we spend so much time talking about the whole person and holistic care, it is important that you see yourself through the same lens. Looking after patients and their families when they’re at their most vulnerable is so rewarding, but can be draining if we’re not well supported and aware of how to look after ourselves. So get those foundations in place.
It’s a relatively small specialty, so get to know your local Palliative Care people. They will want to support and guide you, give you tips on how training works in your particular region. With the shape of training now at the forefront, it will be useful to know how dual accrediting is working in your particular region.
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