Inadequacy of Palliative Training in the Medical School Curriculum


This report examines the literature on palliative training in the current medical school curriculum. A literature search was conducted to identify relevant articles. Physicians and medical students both report feeling that their training in end-of-life care and in palliative issues is lacking. The literature expresses concerns about the varied and non-uniform approach to palliative care training across medical schools. The authors recommend the development of more palliative training assessment tools in order to aid in the standardization of curriculum involving end-of-life care. In addition, increased exposure to dying patients will aid students in building comfort with palliative care issues. Such a goal may be accomplished through required clerkships or other similar programs.

This is a preview of subscription content, access via your institution.


  1. 1.

    Barzansky B (1999) Education in end-of-life care during medical school and residency training. Acad Med 74(10):S102–S104

    CAS  Article  PubMed  Google Scholar 

  2. 2.

    Williamson KP (2004) Improving knowledge in palliative medicine with a required hospice rotation for third-year medical students. Acad Med 79(8):777–782

    Article  Google Scholar 

  3. 3.

    Darer JD (2004) More training needed in chronic care: a survey of U.S. physicians. Acad Med 79(6):541–548

    Article  PubMed  Google Scholar 

  4. 4.

    Ross DD (1997) Hospice and palliative care education in medical school. J Cancer Educ 12(3):152–156

    CAS  PubMed  Google Scholar 

  5. 5.

    Meekin SA (2000) Development of a palliative education assessment tool for medical student education. Acad Med 75(10):986–992

    CAS  Article  PubMed  Google Scholar 

  6. 6.

    Williams ML (2004) A systematic review of teaching and learning in palliative care within the medical undergraduate curriculum. Med Teach 26(8):683–690

  7. 7.

    Kopetz S (2009) Improved survival in metastatic colorectal cancer is associated with adoption of hepatic resection and improved chemotherapy. J Clin Oncol 27(22):3677–3683

    PubMed Central  Article  PubMed  Google Scholar 

  8. 8.

    O’Shaughnessy J (2005) Extending survival with chemotherapy in metastatic breast cancer. Oncologist 10(3):20–29

    Article  PubMed  Google Scholar 

  9. 9.

    Barclay S (1997) How common is medical training in palliative care? A postal survey of general practitioners. Br J Gen Pract 47:800–805

    PubMed Central  CAS  PubMed  Google Scholar 

  10. 10.

    Tiernan E (2001) Effectiveness of a teaching programme in pain and symptom management for junior house officers. Support Care Cancer 9:606–610

    CAS  Article  PubMed  Google Scholar 

  11. 11.

    Field D (1988) Dealing with dying patients: difficulties and strategies in final-year medical students. Death Stud 12:9–20

    Article  Google Scholar 

  12. 12.

    Anderson WG (2008) Exposure to death is associated with positive attitudes and higher knowledge about end-of-life care in graduating medical students. J Palliat Med 11(9):1227–1233

    PubMed Central  Article  PubMed  Google Scholar 

  13. 13.

    Van Aalst-Cohen ES (2008) Palliative care in medical school curricula: a survey of United States medical schools. J Palliat Med 11(9):1200–1202

    Article  PubMed  Google Scholar 

  14. 14.

    Billings JA (1997) Palliative care in undergraduate medical education. JAMA 278(9):733–738

    CAS  Article  PubMed  Google Scholar 

  15. 15.

    Bickel-Swenson D (2007) End-of-life training in U.S. medical schools: a systematic literature review. J Palliat Med 10(1):229–235

    Article  PubMed  Google Scholar 

  16. 16.

    Horowitz R (2014) Palliative care education in US medical schools. Med Educ 48:59–66

    Article  PubMed  Google Scholar 

  17. 17.

    National Cancer Policy Board (1999) Ensuring quality cancer care. National Academy Press, Washington

    Google Scholar 

  18. 18.

    Sullivan AM (2003) The status of medical education in end-of-life care: a national report. J Gen Intern Med 18:685–695

    PubMed Central  Article  PubMed  Google Scholar 

  19. 19.

    Mermann AC (1991) Learning to care for the dying: a survey of medical schools and a model course. Acad Med 66:35–38

    CAS  Article  PubMed  Google Scholar 

  20. 20.

    Mount BM (1986) Dealing with our loss. J Clin Oncol 4:1127–1134

    CAS  PubMed  Google Scholar 

  21. 21.

    Meir DE (2001) The inner life of physicians and care of the seriously ill. JAMA 286:3007–3014

    Article  Google Scholar 

  22. 22.

    Fins JJ (2003) Reflective practice and palliative care education: a clerkship responds to the informal and hidden curricula. Acad Med 78(3):307–312

    Article  PubMed  Google Scholar 

  23. 23.

    Frey R, Gott M, Raphael D, O’Callaghan A, Robinson J, Boyd M, …, Snow B (2013) Clinical staff perceptions of palliative care-related quality of care, service access, education and training needs and delivery confidence in an acute hospital setting. BMJ supportive & palliative care, bmjspcare-2012

  24. 24.

    Eyigor S (2013) Fifth-year medical students’ knowledge of palliative care and their views on the subject. J Palliat Med 16(8):941–946

    Article  PubMed  Google Scholar 

  25. 25.

    Anneser J (2014) Needs, expectations, and concerns of medical students regarding end-of-life issues before the introduction of a mandatory undergraduate palliative care curriculum. J Palliat Med 17(11):1201–1205

    Article  PubMed  Google Scholar 

  26. 26.

    Do Duc T (2014) Comfort measures only and the value of an informal curriculum. J Palliat Med 17(2):129–130

    CAS  Article  PubMed  Google Scholar 

Download references


The authors wish to thank the generous support of Bratty Family Fund, Michael and Karyn Goldstein Cancer Research Fund, Pulenzas Cancer Research Fund, Joseph and Silvana Melara Cancer Research Fund, and Ofelia Cancer Research Fund.

Conflicts of Interest


Author information



Corresponding author

Correspondence to Edward Chow.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Chiu, N., Cheon, P., Lutz, S. et al. Inadequacy of Palliative Training in the Medical School Curriculum. J Canc Educ 30, 749–753 (2015).

Download citation


  • Palliative
  • Medical school
  • End-of-life
  • Training
  • Education