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Hospice & Palliative Medicine Fellowships

The goals of the fellowship program are excellence in palliative medicine education for interested physicians and to create leaders in the field. Extensive and in-depth clinical education through interdisciplinary faculty focuses on patients with life threatening or limiting advanced diseases.

Fellows will have hands on palliative care experience in palliative approaches to cancer, advanced lung, heart and kidney disease, neuromuscular diseases and other diseases appropriate to palliative care. Fellows will receive training in psychosocial care of patients and families and will learn to conduct family meetings.

Communication skills are taught in afternoon seminars. Fellows are also to taught PowerPoint and lecture presentation skills. Electives include bioethics, chronic pain rehabilitation, interventional pain, radiation, oncology and psychiatry. The Cleveland Clinic is ranked 4th in the country and has attracted internationally acclaimed specialists. The Palliative Medicine program is a WHO demonstration project and European Society of Medical Oncology designated program.

Fellowship appointments are for one year as per ACGME standards. Additional training in palliative care depends on funding opportunities.

Applying for Hospice and Palliative Medicine Fellowship

All required clinical education for entry into ACGME-accredited fellowship programs must be completed in an ACGME-accredited residency program, or in an RCPSC-accredited or CFPC-accredited residency program located in Canada. 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 application process for fellowship is conducted through ERAS®. We are a participant of the NRMP Main Match and therefore, do not fill any positions outside of the Match. Applications will be accepted during the month of July each year for positions to begin July 1st of the next academic year. We encourage applicants to contact the Education Program Manager regarding inquiries into our program (mulgrel@ccf.org):


Lynn Mulgrew
Education Manager
Cleveland Clinic
Taussig Cancer Institute
Hematology/Medical Oncology
9500 Euclid Avenue (R35)
Cleveland, OH 44195
Phone: 216.445.0624
Fax: 216.444.9464
Application Contact Information

We encourage applicants to contact the Fellowship Coordinator regarding inquiries into our program:

Lynn Mulgrew
Program Coordinator
Cleveland Clinic
Taussig Cancer Institute
9500 Euclid Avenue (R35)
Cleveland, OH 44195
Phone: 216.445.0624
Fax: 216.444.9464

Benefits

The Cleveland Clinic is an equal opportunity employer. In addition, international medical graduates must hold a valid ECFMG certificate and meet visa requirements to pursue graduate medical education within the United States and Cleveland Clinic.

Structure

The program consists of multiple services through which each fellow will rotate in four-week blocks. These services include inpatient consult and inpatient service, home and inpatient hospice experience, long term care in conjunction with the geriatric department and a 2 week pediatric experience.

Beginning in 2013 fellows within the program will have the option of selecting from two (2) tracks for training, a hospice track or a palliative medicine track.

Inpatient Service

The 23-bed Harry R. Horvitz Center provides inpatient services for acute palliative care in 2 services; teaching and non-teaching. The maximum number on service is 14. Annual admissions average 900 patients.

While on service the fellow is responsible for the day-to-day care of the patients in collaboration with internal medicine residents, other rotating fellows (pain management radiation, gynecology oncology, oncology and hospitalists) and physician assistants. Rounds with the PA, fellows with the attending are 6 days a week and one day off. Call is from home and in-house coverage is provided at night by hospitalists.

Consult Service

Consults are seen in both the inpatient and outpatient setting. Fellows rotate on the inpatient consult service. Consults are from the department of Hematology/Oncology, from internal medicine and medical subspecialty services and medical and surgical ICUs. The Consult service is staffed by the fellows, nurse practitioner and an attending. Consults are seen the same day. Average annual consults are 900.

Hospice Home Care Service

The Palliative Care program includes a Medicare certified palliative home care program and Hospice of the Cleveland Clinic. The inpatient experience is provided at the Hospice House of the Hospice of Western Reserve. While on service the fellows attend 1-2 interdisciplinary team meetings as well as participate in home visits. The daily census averages 250 patients.

Education

The curriculum focuses on skills and knowledge needed for a specialist in palliative medicine including but not limited to palliative medicine philosophy, ethics, communication skills, symptom control and assessment, decision making, pharmacology, interdisciplinary cooperation, regulatory, cost issues psychosocial care, spiritual care, family systems and conferences and bereavement.

Incoming fellows attend daily half hour core lectures for 6 weeks beginning in July. Grand Rounds, staff teaching case conference, and journal club occurs weekly and morbidity mortality conference monthly. Psychosocial teaching, family systems and care as well as bereavement are taught by the faculty social worker in weekly lecture discussion format throughout the year. Depending on the background of the individual applicant additional education is available in specific diseases (i.e. Oncology).

Teaching is both didactic and informal. Communication training takes place in afternoon seminars. Fellows are expected to prepare educational conferences regularly based on case experiences and journal reviews. There is one four-week elective period per year in which fellows may choose from multiple selections based preference.

Research

Research has a high priority in the Palliative Medicine program. Fellows will be expected to participate in research or quality assurance projects, write abstracts or case reports or Fast Facts suitable for publication as part of the required scholarly work requirement mandated by the ACGME.

While efforts are made to choose projects to meet the clinical interest of a given fellow, they must all fall within the overall research objectives of the program. Fellows will work with one or more of the attending physicians to achieve this goal. The program has conducted active research in pain control, nutrition, common symptom complexes, psychosocial aspects, family conferences and health care delivery issues in palliative medicine.

Conferences

Palliative Medicine conducts many different educational conferences in a given week. In addition, the Taussig Cancer Institute puts on many informal and formal lectures and Grand Rounds. Fellows may take part in these sessions based on interest. There is also an annual educational conference offered in late February or early March.

Vacation/Call

Fellows are on call from home when they are on the Inpatient Service. They are allowed three days educational leave and fifteen vacation days. Neither educational nor vacation time may be taken during the inpatient service rotation to avoid disruption of patient care.

Cancer Answers & Appointments

Speak with a cancer nurse specialist for appointment assistance and for answers to your questions about cancer locally at 216.444.7923 or toll-free 1.866.223.8100.

Monday through Friday from 8 a.m. – 4:30 p.m. (ET).

Referrals

Resources for medical professionals

  • Outpatient appointment referrals: 216.444.7923 or 866.223.8100
  • Inpatient hospital transfers: 800.553.5056
  • Referring Physician Concierge: 216.444.6196 or 216.312.4910.

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This information is provided by Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

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