Hospice & Palliative Medicine Fellowship

Program Information

Quick Facts

ACGME Accredited: Yes
Residents or Fellows per year: 4
Duration: One year
Postgraduate Training Required: Yes
U.S. Citizenship Required: Preferred

Requirements for Consideration

1. USMLE 1, 2, and 3
2. Completion of residency from one of the following ACGME-accredited residency programs: anesthesiology, emergency medicine, family medicine, internal medicine, neurology, psychiatry, pediatrics, physical medicine and rehabilitation, radiation oncology, surgery.

Curriculum

Didactic Activities

Didactic Activities

Educational Experience

Training

Research

Both clinical and educational research opportunities are available to interested candidates. Using mobile phone technology application, we are exploring research in supportive services for breast cancer care.

Additional one or two years of research fellowship opportunity is available to the interested candidates. Fellows devote to research activities with defined numbers of clinical block annually.

Call

The program follows strictly to the Fellow Duty Hours/Fatigue Mitigation Policy. On-call activities are generally at-home call only. Fellows do one weekend of in-house call along with supervising attending physician.

Faculty Supervision

At each training site, faculty closely supervises the fellows and provides feedback. Faculty ensures that the fellows receive appropriate levels of supervision, and establishes supervisory lines of responsibility and clear lines of communication while advancing the fellows’ privilege of progressive authority and responsibility, and conditional independence.

Teaching Hospitals

1. Jackson Memorial Hospital
2. Holtz Children’s Hospital
3. Miami Veteran Administration Hospital
4. University of Miami Hospital
5. University of Miami Hospital and Clinic
6. Sylvester Comprehensive Cancer Center

Training Sites

Site 1: Jackson Memorial Hospital and Holtz Children’s Hospital

Growing palliative care program offers a wide variety of referral bases – cancer and non-cancer patients from a very diverse population with ethnic, cultural, and socio-economic backgrounds. Fellows attend and conduct the weekly IDT care plan meeting and interact with members of various disciplines.

Fellows will rotate 4-week block of pediatric palliative care rotation at the site 1 – Holtz Children’s Hospital (under Jackson Memorial Hospital/Jackson Health System). The Holtz Pediatric Palliative Care Program is a well-established program and is registered in the National Palliative Care Registry. During this rotation, the fellow will be exposed to an experiential learning in pediatric palliative care. The fellow will be under direct supervision of the PC program director Dr. G. Patti Cantwell, MD, an experienced Pediatrician specialized in critical care and palliative medicine. Fellows will also see pediatric patients in home care setting – the TiLLi (terminal illness or life limiting illness) Kids Program. The fellows will attend IDT meeting and spend time with child psychologists, child life specialists, chaplains and social workers.

Site 2: Miami VA Healthcare System (MVAHS)

Established palliative care program which consists of: (1) Palliative Care Consult Team (PCCT); (2) Hospice and Palliative Care Unit (HPCU); (3) Outpatient Palliative Care inclusive of Palliative Care Clinic (PCC) and Clinical Video TeleHealth (CVT); and (4) Bereavement Care Service. There are 3 full-time PC board-certified attending physicians, one ANP, and the dedicated members of IDT including PC trained nurses, a social worker, a psychologist/bereavement care specialist, a chaplain, a recreational therapist and volunteers.
Fellows work with other IDT members, attend weekly IDT meeting and participate in care planning and care transition into various settings after successful management of acute needs. Fellows will learn veteran-specific EOL needs including PTSD, substance abuse, and homelessness.

Outpatient PC services utilize both office visit and TeleHealth encounter for the veterans residing in remote areas.

Bereavement team provides anticipatory grief counseling, bedside ritual, debriefing (for staff and trainees), post-death and bereavement phone calls and mailing, and semi-annual memorial services – has been well-established.

Site 3: University of Miami Hospital (UMH)

Growing palliative care consult team (PCCT) provides consultative and co-managed care in in the private, tertiary hospital teaching hospital setting. Fellows will interact with faculty experts from various specialties and subspecialties during the rotation. The UMH, UMHC and SCCC are robust academically and conducive for learning and research activities.
The inpatient hospice unit (IPU) operated by Vitas Innovative Hospice Care provides inpatient level of hospice care. Annually, there are approximately 500-600 new admissions and average LOS of 7 days. Fellows provide inpatient hospice care under direct supervision of experienced, board certified attending physicians.

Site 4: University of Miami Hospital and Clinic (UMHC)

Palliative care clinic at UMHC provides non-hospice palliative care for patients with advanced, incurable illnesses in ambulatory care setting. The clinic hours are from 1:00 p.m. to 4:00 p.m. and it runs four days per week except Wednesday. The PC clinic works closely with the cancer survivor support group which consists of mental health providers (psychiatrists and psychologists), social workers, a chaplain, integrative medicine physician, rehabilitation and restorative physician, and an acupuncturist. Fellows will learn these integrated support services available to cancer survivors. Elective options are also available to rotate with these experts.

Site 5: Sylvester Comprehensive Cancer Center (SCCC)

SCCC is a renowned tertiary cancer center, offers comprehensive cancer care and is a referral hub for cancer patients from the Caribbean and other South American countries. Various site-disease groups (SDG), bone marrow transplant and stem cell transplant services are available. A well-established pain fellowship program and radiation oncology residency training program will work closely with HPM fellowship program as elective options. The UM PC faculty offers Inpatient PC consult for the patients admitted at SCCC. A large variety of cancer patients at their different stages will enrich fellows’ experience and foster learning by participating in various SDG tumor boards.

Site 6: Vitas Innovative Hospice Care

For-profit community hospice agency with average daily census of around 1600-1700 patients in South Florida, provides home hospice care. Fellows learn both clinical and administrative aspects of home hospice agency. Vitas medical director supervise and educate the fellows during the rotation. Fellows make home visits with various IDT members including nurses, social workers, chaplain in addition to medical visits with the attending physician. Fellows participate in the weekly IDT meeting. Fellows learn the role of hospice medical director and required skills such as eligibility and recertification visits, medical visits, and communication skills with other IDT members in home setting.

Site 7: Jackson Memorial Long Term Care Center

Fellows provide consultation and co-management care for palliative care patients in long-term care setting at the Jackson Memorial Long Term Care Center under direct supervision of attending physician. This rotation offers palliative care experience in the long term care setting and in care transitioning from acute inpatient to long term care. Fellows will also interface with hospice care provided by community hospice agency in this setting.