Hospice and Palliative Medicine

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The Hospice and Palliative Medicine Fellowship Training Program at Memorial Sloan Kettering is offered within the Supportive Care Service in the Department of Medicine. This program is accredited by the Accreditation Council for Graduate Medical Education (ACGME) and accepts and mentors six physician fellows each year, training them side by side with fellows in our preeminent Advanced Practice Provider Fellowship in Hospice and Palliative Care. Doctors who have completed a residency in internal medicine, family medicine, physical medicine and rehabilitation, psychiatry, neurology, anesthesiology, surgery, pediatrics, emergency medicine, radiology, or obstetrics and gynecology are eligible. MSK also provides joint hematology and oncology and palliative medicine training to exceptionally qualified doctors.

Mission

To equip qualified, compassionate, collaborative, committed, and scientifically curious doctors to become specialists and academic leaders in palliative care.

Message from Our Leadership Team

The quality and outcomes of our training are as important as those of the patient care we provide. For the future of the field, we are determined to graduate doctors who not only have mastery of knowledge and skills to meet the most-complex palliative needs of seriously ill people and their families but also have the motivation to advance palliative care through leadership as doctors, educators, scholars, and investigators.

Fellows’ ultimate success will depend on internal resources for resilience and on mutually respectful and fulfilling relationships with colleagues from other professions and disciplines, which our program strongly promotes. At MSK, physician fellows train together with nurse practitioner fellows in palliative care, establishing a solid foundation for the team approach that is the hallmark of both our specialty and all high-yield academic activity.

Judith Nelson, Service Chief; Stacy Stabler, Fellowship Director; Reggie Saldivar, Associate Fellowship Director; and Anjali Desai, Associate Fellowship Director

History

Memorial Sloan Kettering, the world’s oldest and largest cancer center, has long been a pioneer in palliative care practice and training. As far back as the 1980s, MSK’s Kathleen Foley, a neurologist, and Nessa Coyle, a nurse practitioner, began building the field by educating the first pain specialists and palliative care nurses, doctors, social workers, and chaplains. Today, MSK’s Supportive Care Service reflects the experience and maturity of four decades of leadership in complex pain management, psychosocial palliative care, and communication skills training. With rapid growth and over 70 interprofessional team members, we have fully and broadly integrated our training program, clinical service, and research efforts in hospital and outpatient settings across MSK.

Program of Training

This training program aims to develop knowledge and skills for expert palliative care across a broad range of patients, families, and care settings. The core experience is provided by the Inpatient Consult Service at Memorial Hospital, which sees around 250 new patients each month and exposes fellows to unparalleled acuity and complexity of palliative care needs (in terms of both symptom management and communication). This is complemented by training in a robust ambulatory practice utilizing tele-health and exposure to innovative primary palliative care models. We work as a collaborative, interprofessional, and interdisciplinary team, consisting of doctors, advanced practice providers, registered nurses, social workers, a chaplain, and a dedicated palliative-care-trained clinical pharmacist. All members of the team provide supervision, teaching, and structured mentorship to the palliative medicine fellows. In the ambulatory practice, fellows join a team consisting of a physician faculty preceptor and a nurse, and they manage their own panel of patients one afternoon a week.

To provide breadth and balance in the clinical experience, fellows have a variety of rotations. Four weeks are spent with the Palliative Care Service at NewYork-Presbyterian/Weill Cornell Medical Center, where the focus is on providing palliative care to people with a range of diseases other than cancer. Hospice experience is provided in collaboration with the Visiting Nurse Service of New York’s hospice program for eight weeks and with Calvary Hospital’s hospice program for two weeks. Two weeks are spent with MSK’s pediatric palliative care team, with additional time available to those with a special interest or background in pediatrics. Fellows have six weeks of elective time to further tailor the program to their individual educational needs.

Fellows benefit from protected educational time in the form of a weekly Academic Afternoon. Unique curricular elements include a robust multi-component research curriculum, an interactive case-based learning series, resiliency sessions and workshops emphasizing practical skills, group debriefing and processing sessions led by social work, a narrative medicine series, and an ethics/palliative care series.  Lunch is provided and fellows are free from clinical duties as they participate in these sessions. Fellows also attend weekly Supportive Care Service and Department of Medicine Grand Rounds. Training in communication skills includes multiple sessions in the renowned ComSkil program in MSK’s Department of Psychiatry and Behavioral Sciences. We provide support for fellows to attend national palliative medicine meetings.

Fellows have a wealth of opportunities to pursue scholarly work, such as, presenting at grand rounds/national conferences, participating in research projects, contributing to the longitudinal class QI project, and teaching medical students and house staff on a day-to-day basis. For trainees seeking a more intensive research experience, we are fortunate to have funding from the Frances Young Tang Research Fellowship in Palliative Medicine to support a full year of protected time for mentored research and participation in a dedicated interinstitutional research curriculum in cooperation with Weill Cornell Medical College

Educational Objectives

Doctors in the program will focus on the following:

  • palliative care practice within a collaborative, interprofessional, and interdisciplinary team model
  • elements of consultation etiquette for providing specialist palliative care
  • strategies for successful integration of specialist palliative care with primary palliative care
  • diagnosis and treatment of pain syndromes associated with cancer, cancer therapy, and other serious and complex illnesses
  • diagnosis and treatment of symptoms other than pain
  • diagnosis and treatment of the neurological, psychiatric, and psychosocial complications of cancer and other serious and complex illnesses
  • skills for clear and sensitive communication with patients, families, and professional colleagues
  • cultural, spiritual, religious, and existential aspects of palliative medicine
  • care of imminently dying patients, including management of terminal symptoms
  • coordination of care within and across health delivery systems
  • medical direction of hospice and delivery of hospice care
  • critical review of the relevant scientific literature
  • clinical research methods for palliative care investigation

Deadline

The application cycle begins one year in advance of the anticipated fellowship start date. Applications are accepted starting in July via the Electronic Residency Application Service (ERAS), and interviews are offered through October.

Length of Program

One year, with the option to apply for a second year as the Frances Young Tang Research Fellow

Eligibility

Prior to appointment in the program, fellows must have completed a program accredited by the ACGME or Royal College of Physicians and Surgeons of Canada (RCPSC) in family medicine, internal medicine, pediatrics, physical medicine and rehabilitation, or neurology; or at least three clinical years in an ACGME- or RCPSC-accredited graduate educational program in anesthesiology, emergency medicine, obstetrics and gynecology, psychiatry, radiation oncology, radiology, or surgery.

Number of Positions

Six

How to Apply

The Hospice and Palliative Medicine Fellowship Training Program requires the utilization of the July cycle of the ERAS application system to apply and utilizes the National Resident Matching Program to fill all positions. Interviews will begin in late August and continue through October. All applications will be reviewed and ranked by November in preparation for the December match. You are required to submit three letters of recommendation (one must be from your residency or current program director), a personal statement, and test scores (United States Medical Licensing Examination or Educational Commission for Foreign Medical Graduates). 

Additional Information

The fellowship program actively recruits women and minority candidates.

Acknowledgement

The Barbara Ziegler Palliative Care Educational Program is dedicated to the promotion and advancement of pain and palliative care educational and research activities. It provides salary support to one of the six hospice and palliative medicine physician fellows each year. A gift from the Tang Family Foundation supports the Frances Young Tang Research Fellowship in Palliative Medicine, in honor of Dr. Foley.

Program Director

Contact

Tanya Reid
HPM Fellowship Coordinator
Memorial Sloan Kettering Cancer Center
Palliative Medicine Fellowship, Box 8
1275 York Avenue
New York, NY 10065
Phone: 646-888-3460
Fax: 646-888-2735
HPMfellowship@mskcc.org