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Hospice and Palliative Medicine Fellowship Overview

General Information

 

The University of Pennsylvania’s Fellowship in Hospice and Palliative Medicine is a 1-year ACGME-accredited clinical fellowship within the Department of Medicine.  Fellows participate in a high-volume, interdisciplinary clinical program aimed to train future leaders in clinical care and education.

Fellows graduate capable of entering careers in the ambulatory, hospice, nursing home and/or hospital settings.  Fellows develop clinical expertise in symptom assessment and management as well as advanced communication skills with patients, families, and other health care providers.

Fellows also become expert interprofessional educators.  Fellows train in the Stanford Clinical Teaching Framework and build their teaching skills through various rich educational experiences.

Clinical Program

 

Hospice and Palliative Home Care

Fellows will gain extensive experience managing hospice and palliative patients through time spent with the Penn Wissahickon Hospice and Caring Way Programs -http://www.pennmedicine.org/homecare/services/hospice/index.html.  Fellows will participate in a minimum of 25 home visits, and actively participate in the interdisciplinary team meetings.  Fellows will also spend a minimum of 2 weeks on the new 20-bed inpatient unit cares for patients who require acute inpatient hospice services - http://www.pennmedicine.org/homecare/services/rittenhouse/

Inpatient Palliative Care Consultation Service

Fellows will spend a minimum of 4 months with the interprofessional inpatient consultation teams at both the Hospital of the University of Pennsylvania and Philadelphia Veterans Affairs Medical Center.

Outpatient Clinic

Fellows will maintain their own half-day outpatient clinic practice under the supervision of the palliative care faculty.  Fellows will follow new patients longitudinally in the ambulatory setting as well as across settings if the patients are admitted to the hospital, a long-term care facility, and/or hospice.

Long-Term Care

Fellows will learn how to provide palliative care for frail older adults residing in long-term care during dedicated time with the Penn Wissahickon Hospice long-term care affiliates and at the Philadelphia Veterans Affairs Medical Center Community Living Center.

Other Mandatory Rotations

The 2 week geriatric rotation is completed on the Acute Care for the Elderly (ACE) Unit at Penn Presbyterian Hospital.  The 2 week pediatric rotation is completed with the Children’s Hospital of Pennsylvania Pediatric Advanced Care Team (PACT).  The 2 week pain rotation may take place either at the Hospital of the University of Pennsylvania or the Philadelphia Veterans Affairs Medical Center.

Electives

Elective experiences are available in radiation oncology, HIV, neurology (including a specialized ALS clinic), critical care, cardiology, and pulmonary critical care.  Elective time may also be spent in returning to one of the core rotation sites for additional training based on the fellow’s career goals.  Away electives of a maximum of 4 weeks may be arranged, but require prior approval.

Scholarly Activities

Quality Improvement Project

Fellows will be paired with faculty mentors as well as quality improvement experts to help investigate and address quality improvement issues they encounter in the inpatient, ambulatory, or hospice setting.  Fellows are encouraged to participate in a quality and safety initiative at the University of Pennsylvania Health System level.

Scholarly Project

Fellows may elect to have up to 4 weeks of protected time to plan and complete a scholarly project.  Prior scholarship examples include:

 

    • Kumar P, Casarett D, Corcoran A, Desai K, Li Q, Chen J, Langer C, Mao JJ. Utilization of Supportive and Palliative Care Services among Oncology Outpatients at One Academic Cancer Center: Determinants of Use and Barriers to Access. J Palliat Med. 2012 Jun 25.

    • Bauman J, Lysacht S, Gellis Z, Loren A, Ersek M, Corcoran A. Crossing Boundaries and Piloting a Common Observed Structured Clinical Examination (OSCE) for Multiple Disciplines. Jefferson InterProfessional Education Center (JCIPE) Annual Conference presentation, Philadelphia, PA; May 2012.

    • O'Connor NR, Corcoran AM. End-stage renal disease: symptom management and advance care planning. Am Fam Physician. 2012 Apr 1;85(7):705-10.

    • O'Connor NR, Kumar P. Conservative management of end-stage renal disease without dialysis: a systematic review.  J Palliat Med. 2012 Feb;15(2):228-35.

    • Bauman, J, Kapo, J. Vital Communication at the End of Life. Curr Probl Cancer. 2011 Nov-Dec;35(6):310-6.

Mentorship

 

Fellows will be paired with faculty mentors who will guide in the acquisition of competence in the clinical, teaching, research and advocacy skills pertinent to the discipline, serve as a clinical supervisor in an inpatient or outpatient setting, develop curricula, and/or participation in didactic activities.

Fellows will participate in semi-structured peer-mentoring with other fellows.

Fellowship Application

Post-residency physician fellows must meet the following criteria:

  1. Have completed an ACGME or AOA-accredited residency program in    Anesthesiology, Emergency Medicine, Family Medicine, Internal Medicine, Neurology, Obstetrics and Gynecology, Pediatrics, Physical Medicine and Rehabilitation, Psychiatry, Radiation Oncology, or Surgery.

  2. Be board-certified or board-eligible with demonstration of active pursuit of certification.

  3. Demonstrate interest in pursuing an academic career with palliative care as a primary focus.

  4. Individuals who wish to apply for a fellowship should submit an application through ERAS. Your ERAS application should include your curriculum vitae, personal statement, three letters of support, and test scores (ECFMG, USMLE) in order to be reviewed.

  5. We accept applications on a rolling basis.  Depending on the level of interest for a given academic year, we may completely fill our positions more than a year in advance.  Applicants are encouraged to contact us and submit an ERAS application at last a year and a half in advance of their anticipated fellowship start date.   For example, interviewing for July 2014 will begin in January 2013.

We appreciate your interest in our program and look forward to receiving your application.  For more information, contact:

 

Amy M Corcoran, MD, CMD

HPM Fellowship Program Director

Perelman School of Medicine, University of Pennsylvania

Department of Medicine, Division of Geriatrics

3615 Chestnut Street

Philadelphia, PA 19104

Email: palliativefellowship@uphs.upenn.edu

 

 

Announcement

One of our core HPM Faculty, Dr. David Casarett, is the Primary Investigator for a CMS Health Care Innovations Award.  Official press release below:

THE TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA   

June 2012

Project Title:  "Comprehensive longitudinal advanced illness management (CLAIM)"

Geographic Reach: Pennsylvania

Estimated 3- Year Savings: $ 9,427,468

Funding Amount: $ 4,361,539

Summary:  The Trustees of the University of Pennsylvania are receiving an award to test a comprehensive set of home care services for Medicare and/or Medicaid  beneficiaries with advanced cancer who are receiving skilled home care and have substantial palliative care needs, but are not yet eligible for hospice care.  The program will serve five counties in the metropolitan Philadelphia area.  Using care coordination and planning, the intervention will provide in-home support, symptom management, crisis management, and emotional and spiritual support for beneficiaries with advanced cancer, enabling them to remain in their homes and avoid unnecessary and undesirable hospitalizations.

Over a three-year period, the Trustees of the University of Pennsylvania's program will train an estimated 64 workers.  It will create an estimated 16 jobs for home health aides, social workers, and licensed practical nurses.

Additional Training Opportunities at PENN

Robert Wood Johnson Health & Society Clinical Scholars
http://www.upenn.edu/rwjhssp/

Robert Wood Johnson Clinical Scholars Program
http://www.med.upenn.edu/rwjcsp

Center for Excellence in Cancer Communication Research
http://ceccr.asc.upenn.edu/

Institute for Translational Medicine & Therapeutics
http://www.itmat.upenn.edu/education/shtml