The primary aim of this proposal is to meet the manpower needs for physicians trained in palliative care by establishing an integrated palliative care fellowship experience in two medical specialties: hematology/oncology and geriatrics. Through development of new potential faculty rigorously trained in both palliative care and their primary disciplines, this training model will bring the core competencies of palliative care to those medical specialties with greatest responsibility for seriously ill and dying persons, and will promote the stability and sustainability of academic palliative care as an area of continued and central importance in medical education As important as establishing rigorous postgraduate training opportunities in palliative care, is the need to know if such programs are effective at achieving their stated aims. Therefore a central aim of this proposal is to evaluate the impact of the fellowship training program on outcomes of importance for the strength of the academic discipline of palliative care. These include: retention of graduates in academic posts; quality and number of their teaching and research activities in palliative care in general as' well as within their primary specialty; evidence of leadership in palliative care in general and within their primary specialty; and application of valid and feasible measures of trainees' knowledge, attitudes, and skills in the care of chronically, seriously, and terminally ill patients and their families.
