Background. Over a ten-year period, the authors developed and implemented a disease-trajectory-based curriculum in communication skills and psycho-oncology for oncology fellows. Methods. The basic format is a weekly ward round centered on a patient interview and subsequent discussion. More recently, this has been supplemented by a written curriculum. Results. Former fellows and current trainees perceive this training o be an important component of their overall training. Conclusion. This kind of curriculum is one effective model for teaching communication skills and psycho-oncology to medical oncology trainees.