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 Nurse Practitioner 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.
To equip qualified, compassionate, collaborative, committed, and scientifically curious doctors to become specialists and academic leaders in palliative care.
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; and Reggie Saldivar, Assistant Fellowship Director
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 program reflects the experience and maturity of four decades of leadership in complex pain management, psychosocial palliative care, and communication skills training. Recent rapid growth has 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 about 150 new patients each month. This is complemented by training in a robust ambulatory practice, providing continuity of care in the outpatient setting where most oncologic care is delivered. We work as a collaborative, interprofessional, and interdisciplinary team, consisting of doctors, nurse practitioners, registered nurses, a full-time social worker, a chaplain, and a clinical pharmacist. All members of the team provide supervision, teaching, and structured mentorship to the palliative medicine fellows. Fellows have the opportunity to provide palliative care education to MSK’s transitional year residents, rotating house staff, medical students, and staff. 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. Fellows provide overnight coverage from home approximately once a week and share in weekend call coverage.
Fellows have a variety of rotations to provide breadth and balance in the clinical experience. 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 six weeks and with Calvary Hospital’s hospice program for six 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 weekly Academic Afternoons. Lunch is provided, and fellows are free from clinical duties as they participate in a variety of structured learning sessions. Fellows attend palliative medicine and Department of Medicine grand rounds on a weekly basis. 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, where faculty, staff, and trainees often present their work.
All fellows complete scholarly work, selecting from a range of opportunities, including a collaborative quality improvement project designed by each fellowship class. Fellows are encouraged to submit national presentations and peer-reviewed publications. 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 mentored research and participation in a dedicated interinstitutional research curriculum in cooperation with Weill Cornell Medical College.
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
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
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
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).
The fellowship program actively recruits women and minority candidates.
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.