• Robert Horowitz, Robert Gramling, and Timothy Quill.
• Department of Medicine/Palliative Care, University of Rochester Medical Center, Rochester, New York, USA.
• Med Educ. 2014 Jan 1;48(1):59-66.

ContextMedical educators in the U.S.A. perceive the teaching of palliative care competencies as important, medical students experience it as valuable and effective, and demographic and societal forces fuel its necessity. Although it is encouraged by the Association of American Medical Colleges, the only palliative care-related mandate in U.S. medical schools is the Liaison Committee on Medical Education directive that end-of-life (EoL) care be included in medical school curricula, reinforcing the problematic conflation of EoL and palliative care.FindingsA review of US medical school surveys about the teaching of palliative and EoL care reveals varied and uneven approaches, ranging from 2 hours in the classroom on EoL to weeks of palliative care training or hospice-based clinical rotations.ImplicationsPalliative care competencies are too complex and universally important to be relegated to a minimum of classroom time, random clinical exposures, and the hidden curriculum.RecommendationsGiven the reality of overstrained medical school curricula, developmentally appropriate, basic palliative care competencies should be defined and integrated into each year of the medical school curriculum, taking care to circumvent the twin threats of curricular overload and educational abandonment.© 2013 John Wiley & Sons Ltd.

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