Which Fellowship Experiences Matter Most? A Graduate Survey of Perceived Training Value.

ObjectiveTo identify which fellowship training experiences Hospice and Palliative Medicine (HPM) graduates perceived as most valuable.MethodsAnonymous survey of graduates who completed an HPM fellowship at The University of Texas MD Anderson Cancer Center between July 1, 2001 to June 30, 2024. The survey consisted of 42 questions focused on HPM fellows' educational experience. The value of didactic lectures, clinical rotations, and their perception of clinical workload were assessed.ResultsOf 109 total surveys, 68 were completed (62% response rate). Most HPM graduates surveyed (75%) are still practicing palliative medicine. The majority (74%) of graduates were currently working in academic centers. Almost all physicians (97%) rated the HPM fellowship useful. Nearly all physicians surveyed (97%) agreed that their HPM fellowship training adequately prepared them for their current job. Acute palliative care unit rotation was rated as the most useful educational experience for learning several core competencies. Chief Round was rated as the most useful didactic lecture, and most graduates (66%) found being on call useful. There was variability in graduates' perception of workload, with higher burden reported by those not practicing palliative medicine (P = 0.025) and female gender (P = 0.04). Perceived training gaps included experience with non-cancer patients, limited hospice rotations, and desire for more training in goals of care discussions.ConclusionsGraduates reported favorable perceptions of their fellowship training, with Palliative Care Unit rotation and interactive open ended classroom discussions identified as the most valuable. These findings inform future fellowship curriculum planning and ensure access to meaningful clinical experiences.