Hospice & Palliative Medicine - Fellowship Program

Overview

The Brown Hospice and Palliative Medicine Fellowship is offered through the Division of Geriatrics and Palliative Medicine. The one-year ACGME accredited clinical fellowship program was created in 2012 and trains three fellows per year. Primary training sites for inpatient Palliative Care consults are Rhode Island Hospital and The Miriam Hospital, both in Providence, RI and the main teaching hospitals for the Warren Alpert Medical School of Brown University. Hospice training is based at Hope Hospice and Palliative Care, a not-for-profit hospice and palliative care organization caring for patients in Rhode Island and Massachusetts. Hope Hospice is the second oldest hospice in the nation and a major affiliate of Brown.

Goals and Objectives:
The goal of the Brown Hospice and Palliative Medicine Fellowship is to produce new leaders in the field who will provide and model excellent clinical care of seriously ill patients.

Graduates of the Brown Hospice and Palliative Medicine Fellowship program will be able to demonstrate the ability to:

  • Deliver expert clinical care of seriously ill and dying patients in the continuum of care, including acute hospital care, ambulatory care, long-term care, and hospice in the home, nursing home and inpatient unit.
  • Understand the health care delivery system relevant to terminally ill patients of all ages, including funding, regulatory issues, and how health policy is made.
  • Teach and develop curriculum in all settings relevant to hospice and palliative medicine.
  • Effectively understand and participate in hospice and palliative research - in basic, clinical, or health services investigations or in a quality improvement project.

Duration:
The training program, as specified by ACGME, is one clinically-intensive year. All fellows will have the same didactic and clinical curriculum.

Prerequisite Training/Selection Criteria:
Applicants must have completed or be in the process of completing an accredited residency program and be board certified or board eligible in their field. Applicants who are dedicated to the field of Hospice and Palliative Medicine from all fields are encouraged to apply.

Applications are accepted through ERAS. Applicants will be required to have a CV, at least 3 Letters of Recommendation (at least one from the Program Director or the Department Chair), a personal statement, and a USMLE transcript.

Preference will be given to applicants seeking faculty careers, either in research or clinical education, who have strong letters of reference and who have demonstrated excellence in residency training.

Hospice and Palliative Medicine Fellowship Faculty:

Edward Martin, MD MPH FAAHPM

Program Director

Jensy Stafford, MD

Associate Program Director

Gowri Anandarajah, MD

Angela Anderson, MD (pediatrics faculty)

Linda Coffin, MD

Keith Cohen, MD

David Dosa, MD MPH (research faculty)

Dana Guyer, MD

Ruth Levy Guyer, PhD

Richard Long, MD

Donnah Matthews, MD

Brian Mikolasko, MD

Christine Nevins-Herbert, MD

Mercedes Pacheco, MD

Gregory Rachu, MD MPH

Vinay Rao, DO

Jennifer Ritzau, MD

Diane Smith, MD

M. Catherine Trimbur, MD MPH

Additional Palliative Care and Hospice Providers:

Jorge Alfonso, MD

Maroun Azar, MD

Mary Clare Bergen, RNP

Cara Cavazza, RNP

Kaitlin Collins, RNP

Sarah Congleton, RNP

Sarah Rose Lamport, RNP

Julie L’Europa, RNP

Yi-Ying Liu, RNP

Jennifer McCaskie, RNP

Jane McPhillips, RNP

Audra Noonan, RNP

Sandra Perotta, RNP

Amy Sharron, RNP

Steven Stein, MD

Paula Welch, RNP

Sites:

  • Rhode Island Hospital
  • The Miriam Hospital
  • Philip Hulitar Inpatient Center
  • Hope Hospice and Palliative Care
  • Rhode Island Hospital Cancer Center
  • The Miriam Hospital Cancer Center
  • Hasbro Children's Hospital

Educational Program - Basic Curriculum

1. CLINICAL EXPERIENCE - Fellows provide direct patient care during all rotations under the supervision of a teaching attending physician.

A. Clinical components consist of the following rotations:

  • Ambulatory Palliative Care: 1/2 day per week for one year

    • Sites: Comprehensive Cancer Center at Rhode Island Hospital, Hope Palliative Care, Comprehensive Cancer Center at The Miriam Hospital

  • Inpatient Palliative Care: 7 months

    • Adult Palliative Care: Rhode Island Hospital (3.5 months), Miriam Hospital (3 months)

    • Pediatric Palliative Care: Hasbro Children’s Hospital (2 weeks)

  • Hospice: 4 months

    • Inpatient/Home/Long Term Care

    • Chaplaincy

    • Bereavement

  • Elective: 1 month elective of fellow’s choice. Possibilities include, but are not limited to, Hematology-Oncology, Neurology, Interventional Pain Management, Psychiatry, Cardiology, Pulmonary, Pediatrics, Chaplaincy, and international electives.

  • To learn more about rotation sites: https://www.brown.edu/academics/medical/about/hospitals

2. RESEARCH EXPERIENCE - The fellow will be responsible for completing a research or quality improvement project. Fellows meet with a research mentor quarterly to develop a plan for the project.

To learn more about additional research opportunities: http://www.chcr.brown.edu/ http://publichealth.brown.edu/

3. CONFERENCE/SEMINAR DESCRIPTIONS

A. Division Lecture Series:

This half day weekly conference with faculty and fellows of HPM, Geriatrics and Geri-Psych will cover the principals of palliative care, geriatrics and psychiatry. It will also cover topics such as research methodology, study design, and health care administration.

B. Basic Bootcamp:

Fellows will learn basic HPM symptom management and communication skills from core faculty members. Bootcamp will span several days during orientation and equip fellows with the tools necessary to begin fellowship.

C. Hospice and Palliative Care Lecture Series:

This monthly seminar will focus on basic and advanced communication and symptom management skills for the HPM physician.

D. Balint Group:

Hospice and palliative care clinicians meet monthly to confidentially discuss difficult cases, to support one another and to better understand the patient-clinician relationship. This group is facilitated by a mindfulness and workplace wellness coach.

E. Arts and Ethics in Palliative Care:

Fellows meet twice monthly with Arts and Ethics faculty leaders to explore the intersection between the humanities, ethics and medicine with an emphasis on serious illness, death and dying. One monthly session will be in a small group format and will focus on critical reading of texts and/or ethical case discussions. Fellows will write weekly “parallel charts” and receive feedback on content and composition of these narrative reflections. The other monthly session will feature guest speakers representing various artistic disciplines. Fellows will also attend an interactive workshop designed especially for them at the RISD Museum. https://risdmuseum.org

F. Journal Club:

HPM fellows and faculty meet monthly to discuss 1-2 articles relevant to hospice and palliative care from peer-reviewed general medicine or HPM journals.

G. Hospice Medical Directors Meeting:

This monthly meeting covers aspects of hospice administration and the Medicare Hospice Benefit and will provide fellows with the opportunity to learn the administrative responsibilities required of hospice medical directors.

H. Advanced Bootcamp:

Core faculty will teach advanced HPM topics in the second half of the academic year. Sessions will include topics such as program development, teaching and self-care.

I. Complex Care Conversations:

This physician-led training is an intensive 1 day course during the first month of fellowship that will focus on building communication skills, as well as bioethics and prognostication. This session also seeks to explore techniques for reducing burnout and compassion fatigue. Fellows will have an additional opportunity to participate in this course towards the end of fellowship. https://www.brown.edu/academics/medical/education/other-programs/continuing-medical-education/live-conferences/complex-care-conversations-creating-climate-healing

J. Research Mentorship:

Fellows will meet quarterly to discuss their quality improvement projects with research faculty. Fellows are encouraged to seek out additional mentorship with faculty as needed.

K. Camp Braveheart:

Two-day summer bereavement camp held at Camp Aldersgate in North Scituate, RI to support children (ages 4-17) who have lost a loved one. Fellows will attend a planning session and will be excused from clinical duties to work as camp counselors. HopeHospiceRI.org/CampBraveHeart

L. Bereavement Group:

The fellows will attend a weekly bereavement group during their hospice rotation. Each fellow will pick one bereavement group (eg. Loss of Spouse, Loss of Child, etc) to attend for its 6 week duration.

M. Ethics Committee:

Fellows will participate in the Hospice Ethics Committee, a multidisciplinary group to discuss various ethical concerns related to hospice care.

N. Department of Medicine Grand Rounds are held every Tuesday morning at RIH (also broadcast at TMH)

O. Morbidity and Mortality Conference is held every Wednesday morning at TMH

P. Schwartz Center Rounds are held several times per year at RIH, TMH and Hope Hospice and Palliative Care

Q. Case and Board Review:

Fellows and faculty will meet periodically to discuss difficult cases and practice sample board questions.

R. Speaking Engagements:

Fellows are expected to present an M&M, two case conference presentations, an interdisciplinary case presentation, and two journal club sessions. Fellows are also encouraged to submit abstracts for presentation at the AAHPM annual conference. Fellows are encouraged to seek out talk review and feedback through the Program in Educational Faculty development. https://www.brown.edu/academics/medical/education-programs/educational-faculty-development

Interested applicants should submit an application through ERAS (https://www.aamc.org/services/eras/).

Those with further questions should contact:

Edward W. Martin, MD MPH FAAPHM
Hospice & Palliative Medicine Fellowship Program Director
Division of Geriatrics and Palliative Medicine
Department of Medicine
The Warren Alpert Medical School of Brown University c/o Dora Bethel

Rhode Island Hospital
593 Eddy Street
Providence, RI 02903
Phone: 401-444-5248
Fax: 401-444-3397
E-mail: dbethel@lifespan.org

Follow Us On Twitter