Canada PCOC study plan

Map the PCOC patient-care competency framework to your current oncology and palliative practice, listing three strengths and three gaps.

Explain the pharmacology and clinical role of the four main opioid classes (morphine, hydromorphone, oxycodone, fentanyl) in cancer pain, including equianalgesic principles.

Apply a stepwise approach to assess and manage cancer pain, including the WHO analgesic ladder, breakthrough pain, and opioid rotation.

Describe the assessment and management of common palliative symptoms: dyspnea, nausea, constipation, and delirium.

Identify red flags that require urgent referral or dose adjustment in a palliative patient.

Compare the indications, dosing, and adverse-effect profiles of adjuvant analgesics (anticonvulsants, antidepressants, corticosteroids, bisphosphonates, NSAIDs).

Calculate equianalgesic doses for at least three opioid conversions and justify the chosen dose reduction for incomplete cross-tolerance.

List the key drug interactions and monitoring parameters for methadone, ketamine, and dexmedetomidine in palliative care.

Explain the safe use of continuous subcutaneous infusions and syringe drivers, including compatibility and stability considerations.

Identify deprescribing opportunities for commonly overused medications in advanced illness (e.g., statins, bisphosphonates, antihypertensives).

Describe the pharmacokinetics (absorption, distribution, metabolism, elimination) of opioids in patients with renal or hepatic impairment.

Explain the pharmacology of commonly used palliative medications: dexamethasone, haloperidol, metoclopramide, octreotide, and midazolam.

Interpret the significance of CYP2D6 and CYP3A4 polymorphisms for codeine, tramadol, and fentanyl dosing.

Evaluate the evidence for cannabis, ketamine, and lidocaine in refractory cancer pain.

Outline the principles of safe compounding and stability of palliative care formulations (e.g., oral solutions, topical gels).

Apply the ethical principles of autonomy, beneficence, nonmaleficence, and justice to two palliative care scenarios.

Explain the legal requirements for consent, capacity assessment, and substitute decision-making in your jurisdiction.

Describe the regulatory and legal status of medical assistance in dying (MAiD) as it applies to pharmacy practice in Canada.

Identify the pharmacist's role and legal obligations in palliative sedation and withdrawal of life-sustaining treatment.

Outline the documentation and reporting requirements for controlled substances in palliative care.

Demonstrate a structured approach to breaking bad news and discussing goals of care with patients and families.

Apply conflict-resolution strategies in interprofessional team meetings involving palliative care decisions.

Explain the pharmacist's role in communicating medication changes and deprescribing plans to the care team.

Describe techniques for culturally safe and trauma-informed communication with Indigenous patients and families.

Identify strategies to address health literacy and language barriers in medication counselling.

Map the funding and delivery models for palliative care across Canadian provinces and territories.

Explain the role of the pharmacist in different palliative care settings: hospital, hospice, home care, and residential care.

Describe the process for accessing and managing restricted medications (e.g., opioids, cannabinoids) under federal and provincial regulations.

Identify quality indicators and audit tools for palliative care pharmacy services.

Outline the principles of inventory management and diversion prevention for controlled substances.

Synthesize pain and symptom management knowledge by working through five complex case vignettes.

Apply evidence-based guidelines to optimize medication regimens for patients with advanced illness.

Evaluate the appropriateness of palliative chemotherapy and its supportive care requirements.

Explain the management of oncologic emergencies (e.g., spinal cord compression, hypercalcemia, superior vena cava syndrome).

Identify strategies to prevent and manage adverse drug events in palliative care.

Complete a full-length practice examination under timed conditions.

Review all incorrect answers and create a personalized list of high-yield facts to revisit.

Revisit weak areas identified in weeks 1–7 using targeted resources.

Practice rapid recall of key drug doses, conversions, and legal requirements.

Develop a post-exam continuing education plan for palliative care pharmacy.