Hospice and Palliative Medicine
The Palliative Medicine Service in the Department of Medicine offers a one-year clinical fellowship in Hospice and Palliative Medicine accredited by the Accreditation Council for Graduate Medical Education. Individuals 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. Physicians who have trained in internal medicine and have completed, or plan to complete, training in medical oncology are especially encouraged to apply.
Physicians who are seeking board certification in pain medicine should not apply to this program. We encourage these individuals to apply to the Anesthesiology Pain Management Fellowship offered by the Pain Service in the Department of Anesthesiology and Critical Care Medicine. Individuals who have completed residency training in psychiatry may consider applying for the Clinical Fellowship Program in Psychosomatic Medicine and Psycho-Oncology offered by the Department of Psychiatry and Behavioral Sciences.
- Intensive hospital-based palliative care training at an eminent cancer center
- Academic leadership in cancer pain management since the 1950s
- Highly regarded communication skills training program offered through the Department of Psychiatry and Behavioral Sciences
- Board eligibility for certification in Hospice and Palliative Medicine
The program’s mission is to train physicians to become specialists and leaders in the field of palliative medicine, especially those planning a career in an academic cancer center. The focus of training will be the development of expertise in:
- Diagnosis and treatment of pain syndromes associated with cancer and cancer therapy
- Diagnosis and treatment of non-pain symptoms associated with cancer and other life-limiting illness
- Diagnosis and treatment of the neurological, psychiatric, and psychosocial complications of cancer and other life-limiting illness
- Communication skills with patients, families, and professional colleagues
- Clinical research methods used to address symptom control and quality of life
- Basic principles and practical applications of the medical ethics and legal aspects of pain management and palliative care
- Cultural, spiritual, religious, and existential aspects of palliative care
- Care of the imminently dying patient including management of terminal symptoms
- Assessment and management of patients in community settings, such as home and long-term care
The core training experience is provided on the Palliative Medicine Inpatient Consult Service. During the program, fellows rotate though multiple two-week blocks with our interdisciplinary consult teams cohorted to specific patient populations (e.g., ICU, breast oncology, GI oncology). Our inpatient consult service currently sees approximately 100 new palliative medicine consultations each month and is supported by a dedicated team of nurse practitioners. Attending physicians and other interdisciplinary team members provide supervision and specialist palliative support is provided to medically complex and highly symptomatic patients. Each fellow is also attached to a continuity clinic in our Palliative Medicine ambulatory practice that takes place one afternoon per week and extends through the whole year. This outpatient experience allows fellows to follow patients over time and across care settings and to learn about community services for patients and families. Fellows provide overnight and weekend call coverage for our inpatient and ambulatory consult patients approximately once a week from home.
To provide breadth and balance in the clinical experience, all fellows spend four weeks on the Palliative Care Service at NewYork-Presbyterian Hospital, where they focus on caring for patients with serious illnesses other than cancer. Hospice experience is provided in collaboration with the Visiting Nurse Service of New York Hospice Program. Fellows spend a four-week rotation embedded in one of their home-care teams and a four-week rotation at their inpatient facility, as well as in a long-term care environment. Moving forward, the hospice training is being expanded to include additional weeks at Dawn Greene Hospice. The remaining required rotations include time at a long-term care facility and with our newly formed Pediatric Palliative Care Team. In addition, fellows have four weeks of elective time and four weeks of vacation.
All trainees participate in the weekly teaching and conference activities of the Palliative Medicine Service. Trainees attend the weekly Palliative Medicine Service Grand Rounds and Department of Medicine Grand Rounds. Didactic sessions are held twice a week throughout the year on a wide variety of topics related to palliative care and pain management. Fellows will also receive formal training in physician-patient communication via the Communication Skills Training Program developed by the Department of Psychiatry and Behavioral Sciences. All fellows are required to complete scholarly work. This includes but is not limited to conducting journal club presentations, preparing a lecture for the fellows’ board review, and giving a presentation at the Palliative Medicine Grand Rounds. Fellows are encouraged to complete a quality-improvement project of their choice with mentorship from our faculty. In the past, research projects by fellows have resulted in publications or in abstracts presented at scientific meetings. As of 2014, we are fortunate to have the Frances Young Tang Research Fellowship in Palliative Medicine, which allows us to support one of our clinical fellows to stay for a second fellowship year to pursue original mentored research.
The application cycle begins one year in advance of the anticipated fellowship start date. Applications are accepted starting in July via ERAS and interviews are offered through October.
Prior to appointment in the program, fellows must have completed an ACGME- or RCPSC-accredited program in child neurology, 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 one of the following specialties: anesthesiology, emergency medicine, obstetrics and gynecology, psychiatry, radiation oncology, radiology, or surgery.
The Hospice and Palliative Medicine Fellowship program requires the utilization of the July cycle of the ERAS application system to apply. Interviews will begin in late August and continue through early 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 (USMLE, ECFMG).
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 our six Hospice and Palliative Medicine Fellows each year. A gift from the Tang Family Foundation supports the Frances Young Tang Research Fellowship in Palliative Medicine, in honor of Dr. Kathleen M. Foley.