The curriculum for the Palliative Care Fellowship includes block rotations and several longitudinal rotations. The Fellow also has 4 weeks of vacation and 2 weeks for an elective. The longitudinal curriculum includes a series of introductory didactic experiences (the core curriculum), weekly team meeting, weekly sessions in the palliative oncology clinics and interventional pain management clinic, psycho-oncology training, and the Certificate Program in Bioethics. Below are a list of learning objectives for each required rotation and a selected list of topics covered in the core curriculum.
Palliative Care Fellow Rotations and Goals
Inpatient and Consult Services (6 four-week blocks)
- Perform biopsychosocial assessments of patients
- Develop, implement and monitor symptom management, including appropriate assessment and adjustment of the plan of care
- Coordinate the team providing patient care
- Integrate other disciplines providing consultation into management of patient care
- Coordinate and conduct family meetings
- Discuss advance directives, medical information and health care decision making with patients and families
- Document patient care in the medical record, accurately and appropriately
- Present and discuss teaching cases with other physicians, residents and medical students
- Apply EBM principles and clinical guidelines to the decision making process
Hospice (2 four-week blocks)
- Understand how to do a community assessment
- Perform in-home assessment of patients, identifying family and environmental supports and barriers to care, including patient mobility, nutrition, and safety
- Provide clinical interventions to patients at home, including wound care
- Re-evaluate and treat pain symptoms at home
- Participate in interdisciplinary team meetings with hospice staff
- Understand the major entitlement programs available to patients
- Identify additional needs of family and patient
- Observe bereavement programs and pastoral/spiritual care
Pediatrics (1 two-week block)
- Identify normal stages of cognitive and emotional development for children
- Use the stage of development to provide child-centered care and guide psychological adaptation to dying
- Identify symptom control for life threatening illnesses: e.g.,cancer, HIV, neurodegenerative and metabolic diseases,cystic fibrosis
- Understand physical and emotional problems unique to children and adolescents
- Participate in counseling specific to children and their families
- Initiate pain management protocols for children using pediatric doses
- Identify mechanisms of support for child and family
- Identify special services available for dying children
- Observe bereavement counseling with families; parent, siblings and extended members
Long Term Care Rotation (1 four-week block)
- Observe coordination of clinical interventions specific to the geriatric population
- Participate in prescribing symptom (including pain) management protocols specific to the geriatric population
HIV (10 Longitudinal Consult Sessions)
- Understand how harm reduction can be incorporated into medical care
- Understand and manage the challenges associated with delivering care to a disenfranchised and marginalized population
- Collaborate with community-based organizations in the delivery of health care services
Addiction Medicine (1 two-week block)
- Apply skills of motivational interviewing to treatment of people with chemical dependency
- Identify psychosocial problems specific to chemical dependency
- Identify common psychiatric co-morbidities in MICA patients and treat or refer for treatment
- Identify barriers to care specific to this population
- Appropriately refer patients for treatment
Interventional Pain Management (1 two-week block)
- 1 two week block session to observe and understand options for imaging-guided interventional pain management
- Outpatient Palliative and Interventional Pain Management Clinic (weekly)
- Identify clinical problems requiring intervention
- Coordinate referrals, as needed, for additional care/resources/services
- Develop, implement and monitor a pain and symptom management plan
- Coordinate supportive services for the patient and family
Didactic, Clinical, Research Modules
- Psychosomatic Medicine: 6 monthly case-based teaching fousing on psychologic concerns in medically ill patients.
- Core Psychosocial Curriculum: Psycho-oncology training with the Oncology Fellows. Topics covered include breaking bad news and bereavement.
- Core Bioethics Curriculum: Bioethics certificate Program at Cardozo School of Law
- QI, Writing Group, or Research Project:
- Faculty from Division of Education, Department of Family and Social Medicine
- Decisions, Designs, and Data
- Quantitative and Qualitative Research Methods in Medical Education
- Advanced Literature Review, Databases
- Project mentoring
- CITI online certificate course in the protection of human subjects