Curious - how does one do palliative from EM? Fellowship? Lots of personal reading/education on the topics?
I used to work with a real old school ED doc - she was IM boarded but doing EM with a part time palliative practice on the side, no formal training. Super rural setting.
Always thought it was an interesting practice model.
Indeed there are multiple paths. The formal pathway, and most comprehensive foundation to build a career, is via fellowship -- which is 1 or 2 years depending on the program.
In the past, people could be grandfathered in -- that is no longer an option. Now you either do the training and get board-certified as a subspecialist in HPM or you try to pick it up the same way everyone else picks up new skills and knowledge without formal PGY training (i.e. conferences, seminars, reading, etc) and then apply for jobs as an outsider per se, cross your fingers, and pray you are doing your patients/families justice as you build up experience in realtime.
Historically, places have been quite desperate for docs, so would often welcome applicants without certification -- that phenomenon also has largely started to phase out -- and if you want to enter practice today at an academic institution or be involved as faculty, way more often than not the requirement will be to have completed fellowship.
There are a couple other SDN EM posters in hospice/palliative. I know one has done fellowship and one has not.
6 months into my own fellowship, I can say for me it was 100% necessary, as beyond primary palliative medicine, not much of this stuff was taught in EM residency. My personal opinion is to best serve these patients/families/docs, that are seeing you in search for your subspecialist-level knowledge, you should have the corresponding education and training of such. But, I realize I'm biased as it's the path I chose.
That said, not many medical students or EM residents know about it. I know much of my coresidents and EM faculty were confused during my PGY3 year. It's no worries, it worked out phenomenally. In truth, IM and FM residents get exposure during their residency training -- so it is no surprise that those fields make up the majority of palliative docs today. It is getting more popular over the years with EM. One of my incoming fellows next year at my faculty job is an EM doc that's been practicing as a hospice med director for some time and now returning for formal fellowship training.
Like all things, there is variety.
If you think this might be a career interest for you, explore our SDN sub-forum:
Hospice and Palliative Care Medicine discussion forum.
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