Raising the bar for the care of seriously ill patients: results of a national survey to define essential palliative care competencies for medical students and residents

Acad Med. 2014 Jul;89(7):1024-31. doi: 10.1097/ACM.0000000000000271.


Purpose: Given the shortage of palliative care specialists in the United States, to ensure quality of care for patients with serious, life-threatening illness, generalist-level palliative care competencies need to be defined and taught. The purpose of this study was to define essential competencies for medical students and internal medicine and family medicine (IM/FM) residents through a national survey of palliative care experts.

Method: Proposed competencies were derived from existing hospice and palliative medicine fellowship competencies and revised to be developmentally appropriate for students and residents. In spring 2012, the authors administered a Web-based, national cross-sectional survey of palliative care educational experts to assess ratings and rankings of proposed competencies and competency domains.

Results: The authors identified 18 comprehensive palliative care competencies for medical students and IM/FM residents, respectively. Over 95% of survey respondents judged the competencies as comprehensive and developmentally appropriate (survey response rate = 72%, 71/98). Using predefined cutoff criteria, experts identified 7 medical student and 13 IM/FM resident competencies as essential. Communication and pain/symptom management were rated as the most critical domains.

Conclusions: This national survey of palliative care experts defines comprehensive and essential palliative care competencies for medical students and IM/FM residents that are specific, measurable, and can be used to report educational outcomes; provide a sequence for palliative care curricula in undergraduate and graduate medical education; and highlight the importance of educating medical trainees in communication and pain management. Next steps include seeking input and endorsement from stakeholders in the broader medical education community.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Clinical Competence / standards*
  • Curriculum / standards
  • Education, Medical, Undergraduate / standards*
  • Family Practice / education*
  • Female
  • Humans
  • Internal Medicine / education*
  • Internship and Residency / standards*
  • Male
  • Palliative Care / standards*