Impact and Reception of a Required 4-Week Palliative Medicine Rotation

Abstract

Background and Objectives: Hospice and palliative medicine (HPM) is one of three Accreditation Council for Graduate Medical Education accredited clinical subspecialties available to family medicine graduates for fellowship training. Despite this, training is not currently a curriculum requirement. We have pioneered a required 4-week palliative medicine rotation into the curriculum. Methods: Twenty-eight residents who completed the palliative medicine rotation across four classes were surveyed to assess how the rotation improved their level of comfort with providing end-of-life (EOL) care and to demonstrate the need of formal palliative medicine training. Wilcoxon signed ranks test was used to detect statistical differences between the mean level of comfort of residents pre- and postrotation with providing the basic skills needed to practice HPM. Results: The HPM rotation significantly improved the residents’ level of comfort in all areas of measured EOL care (P<0.001). All residents surveyed strongly agreed that the rotation was valuable to their future and 100% of residents strongly agreed that an HPM rotation should be required. Conclusions: Formal HPM training should be a required component in residency education and considerations should be given to the 4-week format. This rotation provides a model that can be implemented in other residency programs nationally. Implementation of this rotation may help close the enormous gap of patients not receiving quality EOL care.