Hospice & Palliative Care Fellowship Program

The Hospice and Palliative Care Fellowship is committed to addressing the critical palliative care gap in both adult and pediatric medicine that exists in Utah and the Mountain West. This fellowship is hosted in the Department of Internal Medicine, and the fellow will have opportunities to work in a wide variety of hospitals in our large catchment area.

Overview

The University of Utah Medical Center, George E. Wahlen VA Medical Center, Intermountain Medical Center, and Primary Children's Hospital provide comprehensive health care services over a seven state area, including portions of Arizona, Wyoming, Montana, Idaho, Nevada, Colorado, and rural Utah, or approximately 15 percent of the US land mass. A substantial portion of Utah’s population resides outside of the Wasatch front, where the majority of tertiary care services are available. Approximately one-quarter of the population lives in rural or frontier areas.

At the University Hospital, the fellow will work on an inpatient consultation service with a full-time palliative care physician as well as other members of the team including two HPM-certified hospitalist physicians, multiple nurse practitioners, a social worker, and a chaplain. The University Hospital is a tertiary care multispecialty trauma hospital and transplant center. On this rotation, the fellow will be exposed to the full spectrum of chronic disease trajectories, including cardiac, neurologic, geriatric, organ transplant, cirrhosis, cancer, and pulmonary patients.

The Huntsman Cancer Institute at the University of Utah (HCI) is a NCI designated Cancer Center, with exposure to a variety of cancers, end of life care, and treatment related conditions. The palliative care (PC) team sees patients from diagnosis through survivorship, disease recurrence, or end of life. The PC team also works with the pain management team, seeing patients jointly.

Fellow will have a continuity clinic at HCI, where s/he will be supervised by attending physicians who are palliative care board-certified, with expertise in oncology, psychiatry, and pain management. In addition, the fellow will participate in a pain clinic at the University Pain Management Center, a one month rotation. During this rotation, the fellow will participate in the work up and management of a variety of chronic pain patients who are followed with a multidisciplinary team, including pain medicine physicians.

Primary Children’s Hospital (PCH) is a tertiary referral hospital, with approximately 150 new palliative care referrals per year. Because PCH is the only tertiary care hospital for children in a five-state area, the full spectrum of pediatric complex chronic conditions are well represented. PCH also has a well-established palliative care program, Rainbow Kids, to which approximately 110 children have been referred to since its inception in 2007. Nearly 50 percent are still alive and being followed within the program to date.

The fellow will spend one month on service at PCH, participating in daily bedside rounds, performing new consultations, conducting family meetings, attending care conferences, and running weekly IDT meetings. There will be daily contact with all members of the IDT. The fellow will be a member of PCH's Bioethics Committee and will be exposed to common bioethical dilemmas of pediatric care. Fellow’s duties will include participating in consultations, arranging/coordinating team meetings, IDT discussions, and transitions of care. S/he is expected to function as a medical provider within the interdisciplinary team.

Our fellowship has a one day per week, yearlong, longitudinal hospice rotation. We believe that the uniqueness and strengths of our hospice-teaching program are centered around the commitment to longitudinal exposure, our experienced faculty with 1:1 teaching, and the balance between for-profit, not-for-profit, urban, and rural hospice experiences. Fellows will receive training and preparation to take the Hospice Medical Director Certification exam.