Effective internal medicine practice requires a palliative care skill set often developed during residency training. Most internists care for seriously ill patients who need effective pain and symptom management, particularly as they approach end of life. 1 Skilled communication is equally important for serious illness care 2 and is relevant to nearly every clinical encounter. Accordingly, the Accreditation Council for Graduate Medical Education (ACGME) has identified Interpersonal and Communication Skills as a core competency for resident trainees, and effective communication with patients and caregivers as an expected educational milestone. Despite the importance of such primary palliative care skills, trainees report inadequate preparedness to manage serious illness conversations and end of life care. 3–5

While multiple strategies exist to teach these skills, we contend that palliative care faculty involvement as general medicine teaching attendings provides a unique and underutilized opportunity for resident education. As specialists who attend on the medicine wards, we have found that the palliative care skills essential to internist practice may be taught most effectively when they are woven into daily bedside care. Existing palliative care education often occurs within established teaching settings (ie daily conferences and morning report discussions) or special didactic sessions (ie communication skills workshops). While valuable, these experiences may be siloed from residents’ clinical work. A rotation with a palliative care consult service is another space to learn these skills; however, this experience may not be available to all medical residents, can require use of limited elective time, and may not demonstrate as clearly how these skills manifest in generalist practice. When palliative care faculty attend on the wards, they can help residents develop a more perceptive eye for unmet palliative care needs and begin to address them