Senior Medical Student

While many physicians develop an interest in Hospice and Palliative Medicine (HPM) during their residency or later in their careers, if you're considering this field as a medical student you have several opportunities to confirm and prepare for this career path.

Decide on a "Primary" Specialty Choice

HPM fellowship is a subspecialty training pathway available to those who have completed residency training. In addition to emergency medicine (EM), graduates of other residency fields are eligible to enter the fellowship, including: internal medicine, family medicine, surgery, psychiatry, neurology, pediatrics, anesthesia, physical medicine and rehabilitation, obstetrics and gynecology, and radiology.

Complete Elective Rotations

Palliative care intersects with nearly every type of patient and clinical scenario. During your senior clinical year, choose rotations to get a broad exposure, not just in your future residency field. Do the things you won't be able to do as a resident. Spend one or two rotations working with a palliative care team or in a hospice setting. If these opportunities are not available at your medical school, you may be able to complete an away rotation at an outside institution.

Get Involved with Research or Scholarly Activity

While not strictly required for most programs, research productivity is regarded favorably. Many schools require students to engage in some scholarly project, and the intersection of EM and palliative care is fertile ground. Getting a project or two on your CV now will be very useful for future fellowship applications.

Choose Your Residency Wisely

On the residency interview trail, ask how programs provide education and exposure to the field of palliative medicine.

• Does the institution have a robust palliative care program and fellowship?
• Is palliative care education incorporated into the EM didactic curriculum?
• Is there a required (or available elective) palliative care rotation in the curriculum? This is often a necessary prerequisite for HPM fellowship programs.
• Are there EM faculty with HPM expertise in the department?
• Is the residency program three or four years? Either program length can provide sufficient preparation for the field. If you intend to practice clinically in palliative medicine, remember that a fellowship is required, which may make a required fourth year of residency training less appealing.

Take Advantage of National Organizations and Conferences

Many organizations have significantly reduced-price memberships available for medical students. Consider attending the annual meetings of SAEM, ACEP, AAEM, or AAHPM. These conferences typically offer programs tailored for medical students, as well as lectures and interest group meetings that unite individuals from various career stages with an interest in emergency department palliative care.