tag:blogger.com,1999:blog-13495125.post905488365564791362..comments2009-10-18T13:24:07.166-05:00Drew Rosielle MDhttp://www.blogger.com/profile/04345646798042773615drosielle@gmail.comBlogger2125tag:blogger.com,1999:blog-13495125.post-90716937848645986322009-10-18T13:24:07.166-05:002009-10-18T13:24:07.166-05:00Ryan I think your experience is (thankfully) becoming rarer and I wouldn&#39;t extrapolate from any single institution. If you hope to actually practice as a HPM specialist (even if part-time) I would highly recommend getting fellowship trained and board certified. The model that you are describing at Yale, which was essential to the growth and establishment of the field, and which will be around for a while, is going away. Palliative care programs, academic or otherwise, will increasingly expect their physicians to be boarded - and you won&#39;t have any options for doing that without a fellowship. <br />I think combined careers (onc &amp; hpm, geriatrics &amp; hpm, peds &amp; hpm, primary care &amp; hpm, etc.) are a great option and hopefully will be viable in perpetuity: that&#39;s different however from not seeking fellowship training.Drew Rosielle MDhttp://www.blogger.com/profile/04345646798042773615noreply@blogger.comtag:blogger.com,1999:blog-13495125.post-32203548445091808612009-10-17T14:44:24.782-05:002009-10-17T14:44:24.782-05:00This is great news. There are a few of us interested at Yale, and I&#39;ll help spread the word to others.<br /><br />I don&#39;t know what other medical schools are like, but I have had zero encounters with fellowship grads here, and I&#39;m not sure if they exist at all in our system. Our EOL gurus are from intensive care, heme-onc, medicine, and anesthesia, and they are generally less enthusiastic about the HPM fellowship path. I&#39;ll be interested to get a second opinion.Ryan B.noreply@blogger.com