A student-initiated elective on end-of-life care: a unique perspective.

Traditionally, curriculum change is a faculty responsibility. However, a first-year medical student, inspired by previous interactions with cancer patients and disillusioned with her education on the physician's role at the end of life, successfully initiated and sustained an end-of-life curriculum change. This article briefly describes the Preceptorship on End of Life Care and then shifts focus to five key dilemmas associated with student-led curriculum change. These dilemmas include articulating the benefits of student-initiated curriculum change, securing resources for curriculum change, the use of peer versus faculty facilitators, determining whether to create an elective or required curriculum, when to offer the course, and how to transition to new student leadership. Recommendations for students/residents seeking to initiate curriculum change are provided, highlighting the need for a collaborative approach of faculty, community affiliates, and students for sustained success.