Fellowship Curriculum
Our 12- month curriculum includes:
- 6 months of inpatient adult consultation service (4 months at the University Medical Center and 2 months at Memorial Medical Center)
- Weekly outpatient palliative care clinic (1/2 day per week) throughout the year
- 2 months of hospice care
- 1 month of long-term care and geriatric home visits
- 1 month of pediatric palliative care, including home visits with Notre Dame, the largest pediatric hospice and palliative care provider in Massachusetts
- 2 months of elective and scholarly time, including additional time for scholarly projects throughout the year
Curriculum Overview
Our clinical rotations offer robust exposure to the interdisciplinary practice of palliative medicine across settings: inpatient consultation at a safety net quaternary care center as well as a community hospital; inpatient hospice and home based hospice and palliative care; inpatient and home-based pediatric palliative care; long term care rotations in community nursing homes; a weekly half-day in longitudinal palliative care outpatient clinic; and robust opportunities for scholarly activity and elective time tailored to the fellow’s unique career goals. We strongly value continuity of care, and fellows will have the opportunity to continue to follow people seen in the inpatient setting during their continuity clinic. They can also continue to follow patients seen in continuity clinic if and when they enroll in hospice.
Rotations
Inpatient Consult Services (6 months): Fellows spend 4 months at UMass Memorial Medical Center - University campus, which is the major safety net hospital serving Central and Western Massachusetts. We are a Level 1 Trauma Center, Comprehensive Stroke Center, Heart and Vascular Center, and Children’s Medical Center. Fellows care for patients with complex hematologic and oncologic diagnoses, patients undergoing solid organ and bone marrow transplantation, patients in medical, cardiac, surgical, and neuro-critical care ICUs, and patients awaiting LVAD placement or receiving ECMO support. Fellows spend 2 months at UMass Memorial Medical Center - Memorial campus, which is a community hospital with a Level III Neonatal Intensive Care Unit, a robust gynecologic oncology and colorectal surgery service, and medical and surgical ICUs. Fellows have the opportunity to refer people seen in the inpatient setting to their outpatient palliative care clinic to enable continuity of care.
Ambulatory Palliative Care (1/2 day per week throughout the year): Throughout the year, fellows will see patients with a variety of serious illnesses in outpatient clinic ½ day per week. Our clinic is embedded in the Cancer Center, but we see patients with a variety of serious illnesses and have collaborations with our cardiac, pulmonary, and ALS specialists. We strongly value continuity of care, and our fellows have the opportunity to continue caring for their patients if and when they enter hospice care.
Hospice (2 months): Fellows see patients at home and in nursing facilities with our community partners, Notre Dame Hospice and VNA Hospice.
Pediatric Palliative Care (1 month): This is a combined inpatient and community-based rotation, enabling fellows to participate in the care of children and families across care settings. Fellows will provide inpatient care in our 30-bed Pediatric Intensive Care Unit and the Children’s Medical Center at University campus. They will participate in community-based care with Notre Dame Health Care’s pediatric palliative care team, which has an average daily census of ~150 children, the largest in Massachusetts. Fellows work closely with child life specialists, pediatric nutritionists, music therapists and other interdisciplinary team members.
Long-Term Care (1 month): At several nursing homes, fellows help address the palliative care needs of older adults and their families under the guidance of expert geriatricians. They become an integral member of the interdisciplinary team, including nurses, social workers, physical and occupational therapists, nutritionists and health aides. Fellows have the opportunity to participate in geriatric home visits to understand the continuity and distinction between the approaches of palliative medicine and geriatrics in the care of older adults.
Electives (1 month): Elective time is an important space in which fellows can explore areas of interest that shape their education and career goals. Our electives include medical ethics; medical humanities; pastoral care; health psychology; quality science and Lean certification; and subspecialty clinical rotations (ALS clinic, multidisciplinary cancer clinics, ECMO/VAD, wound care, among others). Under the supervision of the program director, fellows can also build their own elective opportunity, which is a way to practice curricular development. There is time for ACGME-required scholarly activity built into elective time as well.
Scholarly Activity (1 month): Fellows are expected to complete a quality improvement or research project with a mentor over the year. They can use this month to write manuscripts for publication, prepare grand rounds presentations, or finalize curricular proposals, among other activities.