Strong educational partnerships can lead to more equitable exposure to hospice and palliative care delivery across an increasingly diverse population of medical students.
Many students lack exposure to hospice and palliative care throughout the course of their medical training, an issue compounded among underrepresented minority groups.
The trend has exacerbated disparities among underserved populations who oftentimes do not receive care from clinicians representative of their cultural beliefs and values, according to Dr. Lindsay Haines, assistant professor at the University of Pennsylvania’s Perelman School of Medicine. Haines also serves as associate program director of the university’s hospice and palliative medicine fellowship. She is an attending physician at Penn Medicine, the university’s hospital-based health system, and is a vice chair of diversity, equity and inclusion.
Collaborating with local colleges and universities to offer summer internship opportunities can help fuel more diverse clinical recruitment and retention, Haines said during the American Academy of Hospice and Palliative Medicine (AAHPM) and the Hospice and Palliative Nurses Association’s (HPNA) 2025 Annual Assembly of Hospice & Palliative Care.
“Our program goals are really aimed at increasing early exposure to hospice and palliative medicine to promote diversity and inclusion in the field, recognizing that many medical schools lack palliative care exposure in the pre-clinical and even clinical years,” Haines said during the assembly.
Penn Medicine’s program, the Berkman Summer Internship in Palliative Care, aims to improve awareness of serious and end-of-life care among future clinicians. The program offers medical students career-oriented opportunities in hospice and palliative care with a goal of shoring up the workforce amid swelling demand.
The eight-week internship program is operated in partnership with Penn Medicine’s Palliative and Advanced Illness Research (PAIR) Center and includes on-site experience with interdisciplinary team members serving patients in the home, as well as in outpatient and inpatient settings. The program includes primary palliative care education, communication training, personalized mentorship and networking opportunities.
The hospice and palliative care internship program is reaching its third year and is dedicated to promoting greater diversity and inclusion in the field, according to Haines. The program has seen a total of 57 applicants since its inception, with several individuals identifying as Hispanic or Latino, as well as Asian American. Interns also have included those from the LGBTQ+ community and many first-generation American college students.
“Our program is aimed toward students who have interest in learning more about palliative care and who lack formal palliative care training opportunities at their home institutions, have an interest in health equity, or have diverse backgrounds, interests and experience of note,” Haines said. “We define diversity very broadly, and are really looking to expand palliative care’s reach to a wide range of students.”
Interns are paired up with mentors based on their interests and participate in a research project that allows for stronger development of palliative care skills. Some previous projects have included an AI-based predictive analytics research initiative intended to better identify patients who may benefit from palliative care, as well as the examination of medical cannabis treatments in palliative pain and symptom management. Telepalliative medicine has also been an area of research.
Feedback from the program’s graduating cohorts of clinicians has been positive, particularly from a diversity perspective, Haines stated. Interns who participated in the 2024 program reported a deep appreciation of the breadth and depth of diverse shadowing experiences, she added.
The internship program features a health equity series spanning several topics related to health disparities and ways to address these issues from a clinical standpoint.
“Programs like this help to increase palliative care’s reach early in medical education,” Haines said. “These early, subtle moments can steer your course, leading you somewhere entirely new and far from where you thought you’d be. Students felt that the program led to a more comprehensive understanding of hospice and palliative medicine, a better understanding of the role of the interdisciplinary team and a better understanding of research methods. We also see that the program led to increasing scholar interest in pursuing this as a career.”