Background

ASCO recognizes the need to integrate palliative care throughout the course of cancer treatment, regardless of prognosis. This is increasingly important in the face of long-term treatment toxicities and improvements in survival. Since 2008, when hospice & palliative medicine became formally recognized as a subspecialty, 630 physicians have obtained dual certification in both oncology and hospice & palliative medicine. In the intervening years, residents have independently sought training in both fields in a sequential fashion, however, there have been requests for a combined training option. Starting with the 2022 fellowship match cycle, ASCO has been facilitating an approved ACGME pilot of a combined Hematology/Oncology and Hospice & Palliative Medicine Fellowship.

Purpose

The goal of the combined training is to pilot an efficient pathway for fellows to be dually certified in medical oncology (with or without hematology) and hospice & palliative medicine. The program targets trainees wanting to advance research in symptoms science and further their palliative care skills to be able to deliver high-quality cancer care with palliative/supportive care integrated across the continuum of care.

Program Description

This flexible pilot allows participating institutions to offer the option to decrease the total duration of training by 1 year by omitting some elective or research time from standard medical oncology or standard hematology/oncology training and by providing training months that fulfill requirements for both subspecialties. Other participating institutions have elected to add an additional research year to standard training. These decisions are institution specific. 

Current ABIM Training Time Standards

Proposed Training Time Standards

Key: CO = clinical oncology months; CH = clinical hematology months; CHP = clinical hospice and palliative months; ER = elective/research months

Option 1 offers a combined training program in medical oncology and hospice & palliative medicine of 24 months total duration. Those 24 months are all clinical and do not represent a reduction in total clinical training in each discipline. A half-day continuity outpatient clinic experience is required throughout the duration of fellowship training.

Option 2 offers a combined training program in hematology/oncology and hospice & palliative medicine of 36 months total duration. Only 6 months of the 3-year training scheme are devoted to elective or research time. A half-day continuity outpatient clinic experience is required throughout the duration of fellowship training.

Note: Each participating institution will offer one of the above options. Some of the participating institutions also offer an additional research year. View the full Combined Oncology and Hospice & Palliative Medicine Training proposal.

Institutional Participation 

Required Items:

• Fellowship program must have a status of continued accreditation.
• Fellowship program must submit letter to the ACGME committing to the elements approved in the pilot proposal.
• Fellowship program must submit formal application to the ACGME (obtaining the necessary support and signatures from local leadership).

Process & Next Steps for Institutions:

• Contact the ASCO Professional Development Team to receive necessary documentation and instructions for submission.
• ASCO recommends submitting required documentation by early Spring to allow time for ACGME approval and program advertising (website and locally) before applications open.
• Please note, after programs receive ACGME approval:
  • ASCO will list your program in the table below and invite program leadership to the fellowship advisory group meetings.
  • Programs should add track in NRMP (“Hematology/Oncology & Hospice and Palliative Medicine”).

How Candidates Can Apply

• Fellowship programs listed below accept applications via the Electronic Residency Application Service (ERAS).
• Fellowship programs listed below participate in the National Residency Match Program (NRMP). Single NRMP match per institution to train in Oncology, HPM, and for some programs, Hematology.
• For additional information, including eligibility and how to apply, please visit the institution’s websites linked below.