A team led by researchers at the Dana-Farber Cancer Institute in Boston, Massachusetts surveyed more than 2000 students and staff at 62 US medical schools to assess the availability and quality of instruction in end-of-life (EOL) care. The team also analyzed medical students' competency in EOL care as measured by responses to selected items on the US Medical Licensing Examination. The Dana-Farber team initiated the work as a subcontractor to Brown University under a major research project in EOL care supported by the Robert Wood Johnson Foundation. Key findings of the survey are as follows:

* More than 90% of respondents had positive views about the responsibility of physicians to help patients at the EOL prepare for death.

* Less than 18% of students and residents reported receiving formal EOL care education.

* More than one-third of students (39%) and 31% of residents felt unprepared to address patients' fears about death and dying.

* Nearly half of the student respondents "felt unprepared to manage their feelings about patients' deaths or help bereaved families."

* More than 40% of respondents in all three survey groups reported that attending physicians and residents in their hospitals did not view dying patients as good teaching cases and did not consider meeting the psychosocial needs of dying patients to be a core clinical competency.

The report is available in detail on the RWJF Web site (http://www.rwjf.org/reports/grr/041472.htm).