A study, published by Dana-Farber researchers in the September 2003 issue of the Journal of General Internal Medicine, suggests that increasing medical students’ opportunities to learn about end-of-life care will require not only curriculum changes, but a re-examination of some of the unspoken rules that govern medical education. “The tremendous growth of hospice and palliative care in recent years has generated many initiatives to improve the training of students in caring for patients near the end of life,” says lead author Amy Sullivan. “But these programs won’t produce real change unless they also address the ‘hidden’ curriculum of medical schools – the values, attitudes, and beliefs that constitute the basic culture of medicine. Our findings show that the medical school curriculum and culture currently do not adequately support good end-of-life care.” The good news is that, knowing which elements of the “hidden” curriculum contribute to the problem, medical school and residency program administrators are now in a position to correct them, says the study’s senior author, Susan Block, chief of Psychosocial Oncology and Palliative Care in the Department of Medical Oncology. The new study is the first to examine the status of medical education in end-of-life care at the national level.