Senior medical students at the University of Michigan Medical School now can become trained clinical ethics consultants early in their careers, instead of waiting until after completing a graduate degree. Six students have completed a pre-doctoral clinical ethics fellowship program to date.

“We were motivated by an opportunity to re-envision how to train the next generation of physician-ethicists, given changes to the medical school curriculum allowing more flexible and self-directed scheduling that availed a chance to pilot a novel program,” says Andrew G. Shuman, MD, FACS, HEC-C, co-chief of the clinical ethics service at University of Michigan Medical School Center for Bioethics and Social Sciences in Medicine.

Students spend about 40 hours a week on ethics service for at least six months and conduct at least 50 formal consults. Two faculty ethicists recently rated fellows’ consultation notes before and after the program, using the Ethics Consultation Quality Assessment Tool, and found scores improved.1

For physicians anticipating prolonged post-graduate training, a key advantage of this program is it happens concurrently with the medical school curriculum. “This means that the pre-doctoral fellow will not need to delay graduation,” Shuman says.

There were some logistical challenges with program implementation. “These were ameliorated by a supportive medical school administration and overwhelming enthusiasm of the students and involved faculty and staff,” Shuman reports.

The results demonstrated that a predoctoral fellowship in ethics can improve senior medical students’ knowledge, experience, and application of clinical ethics. “Their involvement facilitated the productivity of the service, contributed to patient care, and demonstrates the program’s ability to produce trainees that effectively incorporate ethics into clinical care,” Shuman says.


  1. Feder KJ, Chao SK, Vercler CJ, et al. A pre-doctoral clinical ethics fellowship for medical students. J Clin Ethics 2021;32:165-172.