Until two summers ago, Bob Jeske, a University of Miami Miller School of Medicine student, had a commonly mistaken idea about hospice.
“To most medical students, hospice means where people go to die,” says Jeske, a native of Springfield, Minnesota, who aspires to be a rural family doctor. Jeskes perception of hospice changed drastically, however, after he participated in 2006 in an elective end-of-life fellowship program sponsored by VITAS Innovative Hospice Care® and the American Medical Student Association (AMSA). The six-week fellowship is hosted every summer by VITAS Broward County, Florida, program in Fort Lauderdale.
Jeske says his rotation in the program radically improved his understanding of hospice. “Hospice feels like the way medicine is supposed to be,” he says. “Its about talking to patients about what they want not what the doctor wants. In medical school, were taught to focus on the disease and do whatever we can to fight it because death is the enemy.
“Hospice is not typically taught in medical school,” continues Jeske. “More and more palliative care programs are sprouting up at schools around the country, and thats good. But there is still very little discussion about death,” and how to treat patients approaching that threshold.
“You cant face your own death if you cant even talk about it with a dying patient,” says Jeske.
Now entering its sixth year, the AMSA program introduces tomorrows doctors to end-of-life care in real-life settings, explains Joan Hedgecock, associate director of program development for AMSA, which is based in Reston, Virginia.
AMSA selects six to eight students each year from 25-30 applicants based on essays, professors references and other criteria. “We look for students who dont need a lot of supervision, since much of their work like hospice work is self-motivated,” says Hedgecock
The program incorporates lectures, shadowing, visits to homes and facilities, and case presentations and debriefings with VITAS team physicians. At the end of the program, each fellow must develop an end-of-life curriculum project to implement at his or her medical school. Previous fellowship students have coordinated end-of-life speaker panels and hospice shadowing programs. Jeske organized a memorial service for the individuals who donated their bodies to his school for medical research.
Dr. Paul Rozynes, medical director for VITAS Broward program and chairman of the fellowship program, says the goal is to change the philosophy of medical schools in the United States and get them to add hospice medicine to their regular curricula.
Megan Banis, a 2007 AMSA Fellow and second-year medical student at Northeastern Ohio Universities Colleges of Medicine, says such a change in curriculum can only benefit some patients.
“At some point, curative treatment becomes ineffective and palliative care becomes a patients best option,” says Banis. “If physicians arent informed about palliative and hospice care, then they arent presenting their patients with all available options.
“After witnessing people experiencing a good death through this fellowship program, my perception of death has changed both professionally and personally,” Banis concludes. “It has allowed me to accept and deal with death more effectively as an inevitable outcome in some cases, and that will ultimately help me help my patients.”
Until two summers ago, Bob Jeske, a University of Miami Miller School of Medicine student, had a commonly mistaken idea about hospice. 
