Hospice & Palliative Care Fellowship Program

The Hospice and Palliative Medicine Fellowship is committed to addressing the critical palliative care gap in both adult and pediatric medicine that exists in Utah and the Intermountain West. This fellowship is hosted in the Department of Internal Medicine; while 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 medicine physician and HPNA board certified APRN, as well as other 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 Comprehensive Cancer Center, with exposure to a variety of cancers, end of life care, and treatment related conditions. The palliative care, known as Supportive Oncology & Survivorship (SOS) team sees patients from diagnosis through survivorship, disease recurrence, or end of life. The SOS team also includes pain management and psychiatric physicians, as well as a team of HPNA certified APRNs.

The HPM fellow will have a continuity clinic at either HCI or in a chronic serious illness clinic at University Hospital, where s/he will be supervised by attending physicians who are palliative medicine 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 psychologists and physical therapists.

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, caring for over 200 children since its inception in 2007. Nearly 50 percent are still alive and being followed within the program to date.

The fellow will spend at least 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. 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 the uniqueness and strengths of our hospice-teaching program are centered on 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. Pediatric patients are included in the hospice experience. Fellows will receive training and preparation to take the Hospice Medical Director Certification exam.

Finally, the fellow will have a three to four week elective with options of furthering interests in research, publication, integrative medicine, radiation oncology, etc.