Research Article of the Month

Zirulnik A, Meehan C, Markwalter D, Gabbard J, Tilly A, Zimmerman P, Stafford J, Brooten J. Emergency Physicians and Hospice and Palliative Medicine: A Growing Trend in Fellowship Training. J Pain Symptom Manage. 2025 Dec;70(6):e498-e503. doi: 10.1016/j.jpainsymman.2025.08.036. Epub 2025 Sep 1. PMID: 40902736; PMCID: PMC12768106.

Purpose

To quantify and characterize the trend in Emergency Medicine (EM) physicians applying to and matching into Hospice and Palliative Medicine (HPM) fellowships in the U.S. from 2016 to 2023, and to compare this trend with other primary specialties.

Key Findings

Substantial Growth in EM Applicants:

The number of EM physicians applying to HPM fellowships increased 400% over the study period (from 11 in 2016 to 55 in 2023). This growth far outpaced the overall increase across all specialties.

High and Consistent Match Rates:

EM-trained applicants had a high successful match rate into HPM fellowship programs (average 85.4%), peaking at 92.9% in 2022, consistently demonstrating competitiveness and successful placement.

Fastest Growth Among Specialties:

When compared with other primary specialties (internal medicine, family medicine, etc.), EM showed the fastest annual increase in matched HPM applicants, with an average yearly growth rate of ~27%.

Interpretation

The rapid increase in EM physicians seeking formal HPM training reflects growing recognition of the importance of palliative care skills within emergency medicine practice.

This trend suggests that more EM clinicians see structured fellowship training as valuable for integrating serious illness care, symptom management, communication skills, and coordination with palliative care teams into their practice.