Annals of Surgical Oncology

, Volume 22, Issue 6, pp 1761–1767 | Cite as

Palliative Care Training in Surgical Oncology and Hepatobiliary Fellowships: A National Survey of the Fellows

  • Albert Amini
  • John T. Miura
  • Greg Larrieux
  • Susan Tsai
  • Kiran K. Turaga
  • Kathleen K. Christians
  • Karen J. Brasel
  • T. Clark Gamblin
  • David E. Weissman
  • Ann B. Nattinger
  • Fabian M. Johnston
Palliative Care



Surgical oncologists (SO) and hepatobiliary (HPB) surgeons frequently care for patients with advanced diseases near the end of life, yet little is known about their training, comfort, and readiness in the provision of palliative care. This study sought to assess the quality, adequacy, and extent of palliative care training and the readiness of SO and HPB fellows in delivering palliative care.


A self-administered survey was distributed to all fellows enrolled in Society of Surgical Oncology (SSO) and HPB fellowships during the 2013–2014 academic year. The survey assessed attitudes, training, experience, and readiness of fellows in caring for patients at the end of life. Descriptive analysis was performed, and Chi square, Student’s t test, and the Mann–Whitney U test were used to compare mean or median values as appropriate.


The response rate was 47.2 %, and 50.9 % of the fellows reported exposure to a palliative care specialty service during their fellowship. Of the study participants, 75 % observed their faculty discussing the side effects of surgery compared with 54 % who observed faculty communication with patients regarding end-of-life goals (p < 0.01). On the other hand, 40 % of the fellows were never observed by faculty discussing symptoms management, goals of care, or hospice referral with patients, and 56.7 % never received feedback on their palliative skills.


The fellows rated the quality of their palliative care education as poor compared with other aspects of their fellowship training, implying the lack and need of palliative care teaching. Surgical oncology and HPB fellows and ultimately patients may benefit from increased clinical and didactic palliative care training.


Palliative Care Advance Care Planning Patient Care Activity Oncology Fellow Palliative Care Education 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors acknowledge the Foundation of Surgical Fellowships for its support.


No relevant financial disclosures.


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Copyright information

© Society of Surgical Oncology 2014

Authors and Affiliations

  • Albert Amini
    • 1
  • John T. Miura
    • 1
  • Greg Larrieux
    • 1
  • Susan Tsai
    • 1
  • Kiran K. Turaga
    • 1
  • Kathleen K. Christians
    • 1
  • Karen J. Brasel
    • 2
  • T. Clark Gamblin
    • 1
  • David E. Weissman
    • 3
  • Ann B. Nattinger
    • 4
  • Fabian M. Johnston
    • 1
  1. 1.Division of Surgical Oncology, Department of SurgeryMedical College of WisconsinMilwaukeeUSA
  2. 2.Division of Trauma and Acute Care, Department of SurgeryMedical College of WisconsinMilwaukeeUSA
  3. 3.Medical College of Wisconsin Palliative Care CenterMedical College of WisconsinMilwaukeeUSA
  4. 4.Department of Medicine, Center for Patient Care and Outcomes ResearchMedical College of WisconsinMilwaukeeUSA

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