Career Pathway

Hospital-based Palliative Medicine Consultant and Fellowship Director
Drew Rosielle, MD

Institution: University of Minnesota Medical Center

How did you get in to HPM?
I went straight into HPM after residency training.  In medical school I had very little exposure to palliative care.  In fact I had none outside of hospice settings - it just wasn't part of the curriculum and the hospitals at my medical school had no clinical programs then.  Some part of me knew that caring for patients and their families as they approached death was particularly compelling and meaningful to me, so I cobbled together a hospice rotation and really liked it.  During residency I contemplated oncology, geriatrics, and critical care, but realized all of those career paths drew me towards them because I wanted to care for patients at life's end.  I wasn't exposed to palliative medicine much, and still early in my residency wasn't sure that it was a viable career path, other than something that was tacked onto another specialty/practice (primary care, geriatrics, oncology, etc.).  I finally had a mentor reassure me that it was a very viable option (and boy was he right - we still have a major physician shortage) so I decided to go straight into fellowship and have been doing HPM full time since.

What do you enjoy most about your work?
The patient care, and collaborative nature of consultation.  Patients, and their families, are so grateful for what we offer - symptom relief, real options, recognition of the emotional impact of illness and mortality.  In some ways I think palliative docs do it for the instant gratification: no one ever thanked me for my skilled, evidence based secondary prevention of cardiovascular events, or getting their HbA1c less than 7.  But plenty of people thank me and my palliative care team members on a daily basis.  Palliative care is a way to help people in an immediate, tangible way.  The other aspect is the collaborative and consultative aspect of it.  Other doctors and clinicians, who are struggling to figure out the best way to help their sickest patients, or patients that they feel like they are not helping, look to us for help - being able to actually do that is very gratifying.

What advice would you give to someone interested in entering the field?
1)  Do a fellowship
2)  Prior to starting your fellowship, spend your energies on becoming the best physician you can outside of palliative care (whether it's internal medicine, pediatrics, family medicine, neurology, etc.).  Don't take that second HPM elective rotation (unless you need it to decide what you want to do) - take a PM&R rotation, or a hepatology rotation, or something else instead.  To do HPM well, you have to have solid general medicine chops - you'll get all the HPM training you'll
need in your fellowship.
3)  Join AAHPM and go to conferences.