Junior Resident

Early in Residency

Your main focus early in residency should be to learn the basics of being a good emergency medicine (EM) physician, including how to: gather data, develop and prioritize a differential diagnosis, stabilize sick patients, and determine appropriate dispositions.

PGY1 and PGY2

Later in your residency, as a PGY1 or PGY2, it is appropriate to begin looking for a mentor and exploring your interest in the field.

• Take stock of what your resources are at your home institution. Is there a palliative care consult service? Current EM faculty with expertise or interest in the field? 
• Keep a journal about cases that had an impact on you, especially if you have opportunities for complex symptom management, end of life care, or helping patients or families make difficult care decisions.
• Consider joining the American Academy of Hospice and Palliative Medicine (AAHPM), which is free for residents, or the palliative care interest groups at SAEM, ACEP, or AAEM.

Plan for a Rotation with a Palliative Care Service

Planning for a rotation with a palliative care service is a key step in deciding whether fellowship training is the right fit for you down the road. Start the process of organizing the rotation early because it can take several months to set up and rotation slots may fill up quickly at certain institutions. If there's no palliative care program at your hospital, ask to see if it would be possible to complete an elective rotation at an affiliated or outside institution.

Initiate Scholarly Activity Related to Palliative Care

Try to join at least one research, quality improvement, or education project related to EM and hospice and palliative medicine (HPM). This demonstrates dedication, equips you with an academic perspective, and provides compelling discussion points for fellowship interviews. This may be as simple as teaching a didactic session for your fellow EM residents. At some institutions, residents may also be able to join hospital committees (such as Ethics or 'code blue' committees) which consider issues related to palliative and end of life care.