Hospice and Palliative Medicine offers a fellowship in a one-year training program under the leadership of Dr. J. Keith Mansel, after which the fellow is board eligible for the Hospice and Palliative Medicine exam. Our curriculum is designed to offer clinical experience, didactic instruction and intensive communication skills training and practice. Rotations include inpatient palliative consultation, inpatient and home-based hospice, long-term care, and inpatient VA palliative and hospice care. Our fellowship provides inter-professional learning opportunities and collaboration with nurses, chaplains and social workers. Throughout all didactic and clinical experiences, the role and practice of effective communication skills is interwoven as skills are developed in pain and symptom management. There is ample opportunity for an active role in quality improvement and leadership in the growing field of palliative medicine.