Hospice & Palliative Medicine Educational Curriculum
About Our Hospice & Palliative Medicine Curriculum
We have expanded our formal curriculum with each successive class of fellows’ input. Didactics are held on biweekly Friday afternoons, both virtually and on-site at BIDMC, allowing fellows to wrap up their clinical work and end the week with a strong focus on education and skills development. Below you can learn about the longitudinal strands that run through our curriculum and see a sample list of sessions covered in one year.
The core topics consist of lecture- and discussion-based didactics that are curated to prepare fellows for board certification according to the latest ABIM exam content blueprint. In the latter half of the year, we invite subspecialty experts and field leaders across HMS and other institutions, to give our fellows a state-of-the-art overview of palliative care integration in varied disease states and health systems. Fellows will also attend Harvard Medical School-wide clinical case presentations and Grand Rounds lectures.
Pain Management: Basic Opioid Management
Pain Management: Advanced Opioid Management
Care for the Dying Patient
Non-Pain Symptoms: Nausea
Non-Pain Symptoms: Dyspnea and Cough
Non-Pain Symptoms: Constipation, Diarrhea, Wound Care
Non-Pain Symptoms: Hiccups, Pruritus, Insomnia, Fatigue, Cachexia
Management of Depression in Palliative Care
Management of Anxiety in Palliative Care
Managing Pain and Opioid Use Disorder / Buprenorphine
Symptom Management at Home
Ketamine and Lidocaine for Pain
Interventional Pain Techniques
Palliative Radiation Therapy
Palliative Care Emergencies
Medical Aid in Dying
Examining Bias in Palliative Care
Health Care Disparities in Palliative Care
Psychosocial Assessment / Role of Social Work
Spiritual Assessment / Role of Chaplaincy
Hospice: Logistics and Criteria
Hospice: Role of the Hospice Medical Director
Job Negotiations and Career Guidance (Panel)
Prognostication in Palliative Care
Palliative Extubation and Withdrawal of Life Support Therapies
The State of Primary Palliative Care Education
Role of Rehabilitation in Palliative Care
Managing Aspiration / Role of Speech Language Pathologists
Billing/Coding - Best Practices in Palliative Care
Leading a Palliative Care Team (Leadership Panel)
Palliative Care in Oncology
Palliative Care in the Emergency Department
Palliative Care in Heart Disease
Supporting Patients with LVADs
Palliative Care in Neurology
Palliative Care in Kidney Disease
Palliative Care for Pediatric Patients
Hospice Care for Pediatric Patients
Palliative Care Integration in the ICU
Palliative Care in Liver Disease
Palliative Care in Advanced Dementia
Pre-Operative and Peri-Operative Palliative Care
The Serious Illness Communication curriculum occurs monthly, incorporating a blend of lecture-, discussion-, and roleplay-based skills practice. Fellows begin the year by learning communication skills that are foundational to the practice of hospice and palliative medicine. As they hone their skills through clinical practice, the curriculum shifts toward advanced techniques, including how to debrief challenging situations and how to teach serious illness communication. Fellows also participate in Powered by VitalTalk workshops, which are taught by trained VitalTalk faculty facilitators drawn from our program’s faculty and faculty across Harvard Medical School.
Serious Illness Communication 1 (Consult Etiquette)
Serious Illness Communication 2 (Responding to Emotion)
Serious Illness Communication 3 (Building Prognostic Awareness)
Serious Illness Communication 4 (Mapping Goals and Values)
Serious Illness Communication 5 (Making Recommendations and Discussing Dying)
Serious Illness Communication 6 (Discussing Prognostic Uncertainty)
Serious Illness Communication 7 (Fostering Hope)
Serious Illness Communication 8 (When Open-ended Questions and Empathic Statements Don't Work)
Serious Illness Communication 9 (Talking about Miracles)
Serious Illness Communication 10 (Communicating with Hesitant Patients)
Serious Illness Communication 11 (Responding to Trauma and Distress)
Serious Illness Communication 12 (Re-Thinking Advance Care Planning)
GeriTalk/OncoTalk (Powered by VitalTalk workshops with interdisciplinary learners)
Once a month, fellows will join the learning community of the HMS Multicampus Geriatric Medicine fellowship for a half-day of joint didactics. Fellows will learn from leading experts in gerontology and aging research, including topics in Medical Education, fellow-led cases in Clinical Reasoning, and fellow-presented seminars on specialty topics related to aging and palliative care.
Medical education is an institutional focus at BIDMC. Upon graduation, our goal is for fellows to be ready to teach hospice and palliative care skills to the next generation of healthcare professionals. Fellows receive graduated independence during the year, culminating in a “pre-attending” experience during their final month of inpatient palliative care consultation at BIDMC, when fellows will precept a junior learner and receive faculty guidance and feedback on their teaching.
Fellows will learn and refine pedagogical techniques through topics covered in the Geriatrics Co-Curriculum, and will have multiple opportunities to participate in mentored teaching experiences, including in developing lectures and precepting established communication skills workshops for undergraduate and graduate medical learners at BIDMC and Harvard Medical School. Motivated fellows may also consider additional training opportunities in medical education through BIDMC and through the Boston VA.
The field of hospice and palliative medicine needs graduates who can improve serious illness care by leading team operations and generating substantive change within healthcare systems. We prepare our fellows for this crucial work through a longitudinal curriculum in Quality Improvement and Patient Safety, which will teach fellows about the principles and frameworks used in healthcare quality and safety assessment, analysis, and intervention.
Fellows participate in a mentored group project (either ongoing or new), and will be encouraged to submit appropriate projects to national meetings such as the AAHPM Annual Assembly, and local conferences such as the annual Silverman Symposium, which showcases quality improvement work across BIDMC.
Quality Improvement 1 (Introduction to the Course)
Quality Improvement 2 (Forming a Project Team)
Quality Improvement 3 (Understanding the Problem)
Quality Improvement 4 (Designing an Intervention)
Quality Improvement 5 (Studying the Results)
Quality Improvement 6 (End-of-Year Presentation)
Patient Safety 1 (Introduction to Patient Safety)
Patient Safety 2 (Event Analysis Workshop)
Fellows will practice evaluating the hospice and palliative medicine literature by presenting at regular Journal Clubs at both BIDMC and the Boston VA. Interested fellows can be connected with research mentors to participate in ongoing clinical research projects at BIDMC and the Boston VA. At BIDMC, the Section of Palliative Care is housed in the same Division as the Section of General Medicine Research, which includes leading researchers in aging, end-of-life care, and delirium. These researchers have mentored many fellows and junior faculty into successful clinician-investigators. Motivated fellows can also consider applying for the General Medicine Research fellowship after completion of their fellowship year.
Care for the Caregiver is a biweekly event which formalizes our program’s commitment to caring for ourselves and our colleagues, and building a community of support within the fellowship – the same commitments that we make to the wider healthcare system as we become HPM practitioners. This includes fellows-only sessions to process and reflect on the training experience with guidance from a clinical psychologist, and monthly sessions shared by fellows and program leaders, where we engage in exercises around self-care, reflective listening, and personal and professional identity formation.