The Hospice and Palliative Medicine Fellowship curriculum centers on goals and objectives aligned with the ACGME-endorsed competencies of patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, and systems-based practice.
Training
Training for the fellowship consists of 12 months of clinical training and opportunities for clinical research experience in quality improvement and scholarly activity.
During clinical training, the following skills and experiences will be demonstrated:
- Learn to use opiates, dose conversions and narcotic equivalences
- Coordinate and lead family meetings and discussions of complex decision-making
- Learn empathic interviewing techniques
- Demonstrate symptom evaluation and management
- Learn how to discuss palliative treatment options with patients, families and other health-care professionals
- Learn prognostic criteria for patients with advanced and life-limiting diseases
- Perform home care visits in the setting of end-of-life care
- Work with the ethics committee and participate in ethics meetings
- Demonstrate excellence in communication skills among the patient and family unit, other health-care providers and the palliative care team
- Assist in the coordination of care for patients and families including performing functional assessments
- Lecture and teach medical students, nurses, residents and other members of the health-care team on the unique aspects of palliative medical care
- Learn and apply Medicare and Medicaid rules and regulations as it pertains to palliative medicine
- Incorporate patients’ cultural, spiritual and experiential perspectives to customize individual care plans
- How to take a spiritual history and be sensitive to cultural variations and perspectives
Didactics
Fellows are exposed to a broad range of topics through didactic experiences, including:
- Weekly combined Geri-Palliative lectures at SAVAHCS
- Department of Medicine Grand Rounds
- Tumor Board at the Southern Arizona VA Health Care System (SAVAHCS)
- Journal Club at Banner – University Medical Center (UMC) Tucson and SAVAHCS
- Interdisciplinary Team Meetings
- Palliative Care Clinic at the University of Arizona Cancer Center
- Individual projects with faculty mentors
Electives and Rotations
Elective rotations include:
- Oncology Clinic and/or Inpatient Oncology Consultations
- Radiation Oncology
- Medical ICU Palliative care
- Geriatrics
- Pediatric Palliative Care
The typical rotation schedule for the one-year program includes: ***
| Rotations | Minimum Duration | Possible Site Locations |
|---|---|---|
| Inpatient Palliative Experience | 4 months total |
|
| Hospice Experience | 2.5 months total |
|
| Ambulatory Continuity Clinic | ½ day each week for a minimum of 6 months |
|
| Long Term Care Experience | 1 month |
|
| Interventional Anesthesia Pain Service | 2 weeks |
|
| Medical Ethics | 1-2 weeks |
|
| Electives | 1 month |
|
*** Time may vary between sites depending upon funding.