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Becoming a hospice medical director — the complete role guide

The hospice medical director is the physician (MD or DO) who oversees the hospice’s medical component of the plan of care, signs certifications and recertifications of terminal illness, participates in the Interdisciplinary Group, and provides clinical leadership to the entire clinical team. The role blends complex symptom management, regulatory judgment, and organizational leadership.

By Goodwin Hospice Academy Editorial Team·Published February 16, 2026

A day in the life

A typical day: 3–4 hours of clinical direction (chart review, symptom-management consultation with case-managing RNs, face-to-face visits for BP3+ recertifications, complex family conferences), 1–2 hours of IDG meeting participation, 1–2 hours of administrative and leadership work (certifications, QAPI, staff education, medical-director role for a specific IDT).

Education & licensing

MD or DO degree with residency in Internal Medicine, Family Medicine, or Emergency Medicine (most common paths).
Fellowship in Hospice & Palliative Medicine (HPM) — 12 months, ACGME-accredited, strongly preferred.
Active state medical license.
DEA registration.
BLS certification.

Certifications

HPM board certification — ABIM/ABFM Hospice & Palliative Medicine subspecialty

The gold-standard credential. Eligible after HPM fellowship + primary-specialty board certification.

HMDCB — Hospice Medical Director Certification Board

Separate credential specifically for hospice medical directors; especially valuable for physicians without a formal HPM fellowship.

Salary reference

Confirm current hospice medical director compensation on MGMA or the AAHPM salary survey. Compensation varies significantly by employment structure (employed vs contract) and hospice size.

We never publish specific compensation numbers here to avoid drift. Follow the BLS link in Sources below for current, verified data.

Entry pathway

01Complete residency in Internal Medicine, Family Medicine, or Emergency Medicine.
02Complete a 12-month HPM fellowship (ACGME-accredited).
03Obtain HPM board certification.
04Start as an associate medical director at a hospice for 1–2 years.
05Advance to hospice medical director role with an increasing organizational leadership component.

FAQ

Do I need to be a physician to be a hospice medical director?

Yes. Per 42 CFR §418.102, the hospice medical director must be a doctor of medicine or osteopathy. The physician of record may be a nurse practitioner in some contexts, but the medical director must be a physician.

Can I do this part-time?

Yes. Many hospice medical directors serve part-time (0.2 to 0.6 FTE) while continuing a primary-care or hospitalist practice. Larger hospices increasingly have full-time medical directors plus part-time associate medical directors.

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What is Hospice F2F?

What is Hospice Recertification?

What is IDG?

Sources

Educational content only. Confirm current licensure, certification, and compensation data with the linked primary sources.