Development and Execution of a Pediatric Hospice and Palliative Medicine Fellowship in Latin America.

BACKGROUND

Pediatric hospice and palliative medicine (PHPM) is a growing subspecialty worldwide; however, formal graduate medical education pathways remain limited in low- and middle-income countries, including most of Latin America, constraining workforce development and access to specialized care.

OBJECTIVE

To describe an educational innovation that provides formal fellowship training in PHPM to physicians in Latin America.

METHODS

From 2023 to 2026, Unidad Nacional de Oncología Pediátrica (Guatemala), St Jude Children's Research Hospital, and the University of Utah developed and implemented a PHPM fellowship program in Latin America. The curriculum emphasizes culturally responsive training and ACGME International (ACGME-I) core competencies. Program outcomes, feasibility, and acceptability were assessed using mixed methods. Quantitative data were collected via anonymous ACGME-I program evaluation surveys completed by 10 participants over 2 years, representing a 100% response rate from fellows (n=2) and a 57% response rate from core faculty mentors (n=8 of 14 eligible). Qualitative data were obtained from written reflections and monthly structured debriefings with faculty (n=14) and fellows (n=2) from March to August 2025.

RESULTS

Three fellows completed or are completing training, and the program received ACGME-I initial accreditation in February 2026. Graduates demonstrated early workforce impact, including expansion of PHPM services in Chile and planned implementation of the Dominican Republic's first non-oncologic public PHPM program. All survey respondents agreed that the program provided a high-quality curriculum and effective career preparation. Qualitative analysis identified themes of strong mentorship, clinical relevance, and feasibility.

CONCLUSIONS

This trilateral PHPM fellowship is an internationally partnered, regionally grounded training that demonstrates early feasibility, acceptability, and educational value.