What to Expect as a Hospice and Palliative Medicine Fellow

Entire extended faculty (physicians and non-physician providers such as advanced practice providers, nurses, social worker, chaplains)

• Situational: leadership chart — the “big picture”
• Milestones: summative evaluation with program director at four, eight and 12 months.
• Self-evaluation
• “Instant feedback” process
• 360-degree evaluation by the interdisciplinary faculty in hospice and palliative care
• End of rotation faculty evaluations
• In-service exam — HPM Pass, which you will take as a proctored exam in January

Resiliency training

• Monthly meeting with program faculty
• Resiliency didactic curriculum
• System wide “burnout prevention” training

Patient contact requirements

New patients over the course of the program — 100 — This can be either hospice or non-hospice palliative care patients and can be in any venue as long as you are participating in an evaluation on a patient who is new to the program you are working with.

Hospice: 25 “hospice home visits” (that means house calls on hospice patients — could be initial visits, face to face, follow ups, etc.)

Longitudinal experience: Must follow at least 10 patients across settings.

Meetings with program director/associate program director

You will have a meeting with the program director and associate program director the third week of each month on Thursday afternoon for debriefing, informal feedback, questions, concerns, etc.

Institute for Healthcare Improvement (IHI) quality modules

You will be assigned seven of these.

Didactics — Entire faculty, plus selected outside speakers

We provide a comprehensive series of core “lectures” (interactive), both in the weekly “Core Topics” series and didactics specific to the rotations (e.g. hospice). These will touch on essentially all important topics in the field. You will be expected to do six to eight of these lectures yourself to partially fulfill the ACGME requirement that you participate as both “a learner and a teacher.”

Journal Club

Monthly, on the fourth Thursday after Core Topics. Three articles assigned each meeting and one of which is assigned to the fellow. I will assign these at least two weeks prior the meeting. You have 20 minutes to review the article, with these three questions in mind:

• What was the study/article about?
• What were the outcomes or key information presented?
• How is the paper relevant for us as hospice and palliative medicine providers?

Communications training

• Structured communication training using format provided. This is particularly important in the first half of the fellowship year.
• Didactics and roleplaying throughout the year.
• “Instant Feedback” process — New this year.
• Communications “boot camp” at University of Pittsburgh — This is a weekend session in January that you will attend at the expense of the fellowship program.
• “Verbatim training.”

You will be provided with a copy of:

• Primer of Palliative Care — AAHPM - loan
• Care at the Close of Life — JAMA publication - provided
• Essentials of Hospice and Palliative Medicine — AAHPM - loan
• The Hospice Medical Director Manual - provided
• A variety of review articles of interest

We would suggest the following also:

• A comprehensive hospice and palliative medicine text of your choice
• UptoDate has good articles on current state of the art of hospice and palliative medicine.
• Palliative Care: Transforming the Care of Serious Illness — eds. Meier, Isaacs, Hughes
• AAHPM has some great references available to you.