A small paper crane that physician Katherine Morrison, MD, keeps near her desk carries immense meaning. It was created last year by a young adult female patient with a rare type of cancer. For more than a year, the patient frequently visited the University of Colorado Anschutz to receive aggressive treatment. As part of her treatment plan, she also received palliative care from clinicians like Morrison.
“Our team worked intensively with her on managing her pain symptoms, and I think we helped her have a good quality of life during that time,” Morrison says. “She became such an important person in our hospital and wanted to support us back. She would make origami cranes that she and her relatives would leave around for people to find. I still have one.”
The crane is not only a reminder of the patient; it’s a reminder of how important palliative medicine is in helping patients with serious illnesses receive holistic care during such a vulnerable time. It’s the kind of personalized care that Morrison hopes more patients can experience, but a growing national shortage of palliative care clinicians makes that challenging.
Hoping to increase the workforce, Morrison and her colleague Maurice Scott, MD, both palliative care physicians at the UCHealth University of Colorado Hospital (UCH) and associate professors of general internal medicine at the CU Anschutz Department of Medicine, co-direct the Community Hospice and Palliative Medicine Fellowship. This unique online, part-time fellowship helps mid-career physicians become board certified in hospice and palliative care medicine without having to leave their current jobs or communities.
“We have cultivated a real opportunity to exponentially expand palliative care services,” Scott says. “Because our program is co-sponsored by four medical boards and qualified by six others, there is a lot of opportunity for physicians to get involved. It’s such valuable care that I want people to join.”
Palliative care focuses on more than just the medical needs of patients, Scott explains. It involves understanding and prioritizing the patient’s psychosocial, spiritual, and physical wellbeing, as well as supporting the caregivers and loved ones of patients.
This type of care is for patients with serious illnesses — such as cancer, congestive heart failure, Parkinson’s disease, and so on — who are still pursuing curative treatments. It differs from hospice care, which is when patients stop receiving curative treatments and instead prioritize comfort at the end of their life.
“In palliative care, we get to know the patients and their values, and we work with other disciplines in medicine. We’re like translators, looking to align what the patients need and what the medical teams can offer,” Scott says. “We focus on the patient’s quality of life, assessing how we can reduce their symptoms and uplift the patient’s voice.”
For both Scott and Morrison, they found a calling in palliative medicine because they wanted to help vulnerable patients.
“I think some people who are seriously ill or at the end of their lives have historically been ignored by the medical system, but it’s a really important phase of our lives, so I wanted to be there,” Morrison says.
The value of palliative care to clinicians, patients, and their families became evident to Scott during the case of a middle-aged male patient with metastatic gallbladder cancer. The patient’s condition was worsening, requiring support from the intensive care unit team as well as Scott and other members of the palliative care team.
The patient initially asked that the medical teams do anything necessary to keep him alive, but the clinicians felt distress because there were no treatment options left, Scott explains.
“He was a religious man, and over the course of about 10 days, our interdisciplinary team connected with him, his wife, and other members of his church. The day before he died, he said, ‘I have seen the spirit of the Lord. It is time for me to go.’ We transitioned his care to focus on comfort, and he died,” Scott says. “By having these conversations and holding space for the spiritual aspect of this patient, we were able to guide the patient through this journey in a way that made things less difficult for him and less distressing for the medical team.”
Following the patient’s death, the family invited Scott and other members of the care team to the funeral at a local church.
“It was an incredibly powerful experience,” Scott says. “During the service, they called us out as people who helped them make it through this experience. What a gift that was.”
The care model at UCH is interdisciplinary, where social workers, chaplains, therapists, and palliative medicine clinicians work in tandem to provide comprehensive care to patients.
“We’re really fortunate because of the model we have, but it’s rare,” Scott says.
Wanting to expand palliative care services to help patients beyond UCH, in 2016, CU Anschutz faculty member F. Amos Bailey, MD, helped launch an interdisciplinary Master of Science in Palliative Care in collaboration with the CU Anschutz Department of Medicine, Department of Family Medicine, Graduate Medical Education, Skaggs School of Pharmacy and Pharmaceutical Sciences, College of Nursing, and national organizations including the American Board of Internal Medicine and Accreditation Council for Graduate Medical Education (ACGME).
The master’s program is fully online and open to anyone who considers themselves a member of an interdisciplinary team for palliative care, Scott explains. This includes physicians, nurse practitioners, social workers, chaplains, pharmacists, and therapists.
A few years after launching the master’s program, however, physicians began finding that despite completing the program, many struggled to find palliative care jobs without being formally board certified. It sparked the idea of creating a fellowship for physicians so they can get board certified in palliative and hospice medicine.
“Mid-career physicians are somewhat of an untapped resource for filling the palliative care shortage, because they have the life experience and understanding of how important care is for patients with serious illnesses,” Morrison says.
Through support from the ACGME’s Advancing Innovation in Residency Education (AIRE) program, a pilot version of the fellowship program launched in 2020.
“It has been a huge multidisciplinary, multiorganization, and multispecialty effort to put this together,” Morrison says.
In traditional fellowships, clinicians must uproot their lives to complete a year-long program at an institution — a barrier for many mid-career physicians. This fellowship allows physicians to stay in their current roles and communities by offering part-time online training.
To qualify for the fellowship, physicians must first be accepted into the master’s program. After roughly six months, the physician is able to interview for the fellowship program. If accepted, they can overlap some of the master’s program and fellowship work.
Since the training is part time, it typically takes three to four years to complete both the master’s program and fellowship training. Fellows complete academic coursework online with faculty from CU Anschutz, and they complete their clinical work within their community.
“The fellows often work at multiple sites, learning to do inpatient palliative care and hospice, home hospice, outpatient palliative care, and pediatric palliative care. It’s a diverse array of clinical work,” Morrison says. “Most of our fellows end up seeing more than a couple of hundred patients.”
In 2024, Morrison, Scott, and Bailey wrote a report explaining the fellowship’s demonstrated initial success. The following year, the fellowship was named a permanent pathway of the CU Anschutz’s traditional ACGME-approved hospice and palliative medicine program.
“We’re no longer an AIRE demonstration project, because we’ve demonstrated that the pilot worked,” Morrison says. “We’re super proud of that.”
As of 2026, 43 fellows will have graduated from the program, and another 13 fellows will start in the fall. These fellows are located across the country, including Florida, Texas, Alaska, and Hawaii. Despite being remote, the fellows have established strong bonds with one another, often leaning on each other for advice and support.
“In addition to addressing the workforce shortage, a major goal of the fellowship is to help communities that are underserved by palliative care,” Morrison says.
One current fellow is an emergency medicine physician located in a small town in Alaska, Scott explains.
“As a result of this program, he’s helping his hospital build and grow a palliative care program. He’s developed relationships with hospice agencies and is now providing hospice support in the hospital on behalf of these agencies,” Scott says.
Another fellow, Brandy D. Drake, MD, an emergency medicine and hospice and palliative medicine physician at a rural hospital in western Colorado, shares that the fellowship allowed her to continue working in the emergency department as well as launch an inpatient palliative care program at her hospital.
“Our inpatient palliative care service is now five years old and thriving and even expanding into the outpatient realm,” Drake says. “I can't thank everyone in this program enough for their genuine care for me and my goal of bringing palliative care to my region.”
Always wanting to improve the program, Morrison, Scott, and several colleagues interviewed 10 fellowship graduates from the first two cohorts and published their findings in the Academic Medicine journal. The research found that the fellowship continues to demonstrate a promising model for addressing the national shortage of palliative care physicians by helping fellows get certified and obtain leadership positions in their health care systems.
“All 10 of them had passed the boards, and many said they couldn’t have accomplished their current work if they didn’t go through our training,” Morrison says. “One of my favorite quotes from one of our fellows was, ‘I was told at the beginning of starting this fellowship that it would change my life, and it has.’”
Looking ahead, Morrison says the fellowship leaders will continue to improve the program by evolving its training methods, reducing administrative burden, and discovering new ways for faculty at the local sites the fellows are working at to become more involved.
“This is a very innovative model, and we’re still learning,” Morrison says. “We want to continue making it better.”