Publication
Development and Execution of a Pediatric Hospice and Palliative Medicine Fellowship in Latin America
Martinez-Jimenez S, Gradick K, Guarda J, Irwin L, Garcia-Quintero X, Rassam R, Cowfer B, Madni A, McNeil M, Montufar S, Moreira D, Antillon F, Delgado-Corcoran C, Pinargote Pico V, Rivas S · Journal of graduate medical education · 2026
Background: Pediatric hospice and palliative medicine (PHPM) is a growing subspecialty worldwide; however, formal graduate medical education pathways remain limited in low- and middle-income countries, including most of Latin America, constraining workforce development and access to specialized care. Objective(s): To describe an educational innovation that provides formal fellowship training in PHPM to physicians in Latin America. Method(s): From 2023 to 2026, Unidad Nacional de Oncologia Pediatrica (Guatemala), St Jude Children's Research Hospital, and the University of Utah developed and implemented a PHPM fellowship program in Latin America. The curriculum emphasizes culturally responsive training and ACGME International (ACGME-I) core competencies. Program outcomes, feasibility, and acceptability were assessed using mixed methods. Quantitative data were collected via anonymous ACGME-I program evaluation surveys completed by 10 participants over 2 years, representing a 100% response rate from fellows (n=2) and a 57% response rate from core faculty mentors (n=8 of 14 eligible). Qualitative data were obtained from written reflections and monthly structured debriefings with faculty (n=14) and fellows (n=2) from March to August 2025. Result(s): Three fellows completed or are completing training, and the program received ACGME-I initial accreditation in February 2026. Graduates demonstrated early workforce impact, including expansion of PHPM services in Chile and planned implementation of the Dominican Republic's first non-oncologic public PHPM program. All survey respondents agreed that the program provided a high-quality curriculum and effective career preparation. Qualitative analysis identified themes of strong mentorship, clinical relevance, and feasibility. Conclusion(s): This trilateral PHPM fellowship is an internationally partnered, regionally grounded training that demonstrates early feasibility, acceptability, and educational value.
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