ABEM HPM study guide
ABEM HPM · Work through your exam, one topic at a time.
ABEM Hospice and Palliative Medicine (HPM) refers to the subspecialty certification pathway that the American Board of Emergency Medicine lists within the 'Subspecialties' area of its website. Emergency physicians pursue it to document advanced competence in caring for people living with serious, progressive illness - in the emergency department, on inpatient palliative consult services, in hospice settings, and across care transitions. The ABEM HPM study guide has 8 sections and about 2,691 words.
01Palliative Care Approach to Serious Illness: Goals, Prognostication, and Coordination
Palliative care is specialized care for people with serious illness that attends to symptom burden, goals, and quality of life alongside - never instead of - disease-directed treatment. Questions often test whether you can separate three overlapping ideas: the palliative approach (appropriate at any stage, delivered by any clinician), specialty palliative care (consultative, for complex need), and hospice (a Medicare benefit requiring a prognosis of six months or less if the illness runs its expected course, plus a shift to comfort-focused care).
340 words, about 2 min02Pain Assessment and Management
Start with total pain: physical nociception plus psychological, social, and spiritual contributors. Use a validated scale (numeric rating, faces, or behavioral tools such as PAINAD in advanced dementia).
335 words, about 2 min03Non-Pain Symptom Assessment and Management
Opioids are first-line for refractory dyspnea regardless of oxygen saturation; oxygen helps only documented hypoxemia. Simple airflow (fan, open window) and treating anxiety also help.
278 words, about 1 min04Communication Skills and Advance Care Planning
Know at least one structured framework. SPIKES: Set up the conversation, assess Perception, obtain an Invitation (how much detail does the patient want?), give Knowledge with a warning shot, respond to Emotions with empathy, then Summarize a Strategy.
363 words, about 2 min05Psychosocial, Spiritual, and Cultural Aspects of Care
Know the difference between grief and depression. Grief comes in waves, includes yearning and preoccupation with the deceased, and preserves self-esteem; depression has persistent anhedonia, worthlessness, and suicidality.
347 words, about 2 min06Care of the Imminently Dying Patient and End-of-Life Care
Clues include Palliative Performance Scale around 30% or less, bedbound status, minimal oral intake, dysphagia for pills, mottling, cool extremities, oliguria, Cheyne-Stokes respiration, terminal restlessness, and audible secretions. These signs are imprecise individually; the pattern matters.
323 words, about 2 min07Ethical and Legal Aspects of Hospice and Palliative Medicine
Know autonomy, beneficence, nonmaleficence, and justice, and be able to say which principle a vignette hinges on. Decisional capacity requires four abilities: communicating a choice, understanding the information, appreciating the consequences, and reasoning about options.
352 words, about 2 min08Hospice and Palliative Care Program Structure, Quality Improvement, and Reimbursement
The Medicare hospice benefit covers two 90-day periods followed by unlimited 60-day periods, each requiring physician certification and recertification. The interdisciplinary group - physician, nurse, medical social worker, chaplain, aide, volunteer coordinator, and bereavement counselor - reviews each plan of care at least every 15 days.
353 words, about 2 min