Hospice & Palliative Medicine Rotations
Timeframes below are approximate.
Orientation
Fellows spend a didactic block at Trustbridge's Gerstenberg Center at the beginning of the fellowship year. They gain insight into the clinical, regulatory, and administrative knowledge required in the practice of hospice & palliative medicine and are introduced to core foundational skills including empathy, teamwork, and communication.
- Administrative – 2 weeks
Home Hospice
Fellows become part of a Trustbridge hospice home team that cares for patients both at home and in skilled nursing facilities. During the initial block rotation, fellows visit patients with the team physician and other team members to gain insight into the roles and responsibilities of the interdisciplinary team. Thereafter, fellows follow a patient panel on this team longitudinally throughout the academic year. This experience ensures participation in the plan of care from the time of terminal diagnosis through various stages of terminal illness and allows for critical interactions with patients, families, and other support systems.
- Home Hospice – 4 weeks + longitudinal
Inpatient Hospice & Palliative Care
The fellows' inpatient rotations provide intense day-to-day management of a varied spectrum of hospice & palliative care patients. During the first month of fellowship, fellows spend an introductory 2 weeks on the robust, 15-bed Trustbridge hospice inpatient unit located within Delray Medical Center (DMC). Throughout the remainder of the year, fellows spend block months on the inpatient unit where they engage in hospice care and inpatient palliative care consultations. There are additional months dedicated to the busy inpatient palliative care consultation service at DMC.
- Inpatient Hospice Unit and Inpatient Palliative Care Consultations – 20 weeks
Outpatient Palliative Care
Fellows rotate in the Charles Levitetz Advanced Symptom and Support Individualized Care (CLASSIC) Program, one of the area's only outpatient palliative care programs. Not only will fellows learn about assessing and treating the broad spectrum of patients’ palliative care needs, they will also gain appreciation for the day-to-day work done by an outpatient palliative care physician and team.
- Lynn Cancer Institute Charles Levitetz Advanced Symptom and Support Individualized Care (CLASSIC) Program – 4 weeks
Oncology
By rotating in outpatient radiation oncology and hematology-oncology offices, fellows are able to follow patients longitudinally and understand the patient experience and role of palliative care across care settings.
- Lynn Cancer Institute (Delray Beach locations)
- Radiation Oncology – 2 weeks
- Hematology-Oncology – weekly half days over a minimum of 6 months longitudinally
Pediatrics
While rotating with the Pediatric Oncology Support Team, fellows gain a deeper appreciation of the psychosocial aspects of serious childhood illness and its impact on patients and families and develop approaches to maximizing the quality of life for children with cancer.
- Pediatric Oncology Support Team – 4 weeks
Long-Term Care
Fellows rotate at John Knox Village where they gain an appreciation for the complex needs of older adult patients and patients who are appropriate for palliative and hospice care. They acquire experience in assessing older adults’ functional status, nutritional status, social support, advance directives, and goals of care; screening for fall risk, depression, delirium, dementia, incontinence, and polypharmacy; and addressing identified needs using an interdisciplinary approach.
- Long-Term Care – 2 weeks + longitudinal
Electives
Electives are available in a number of fields to meet the interests of the Fellow. Past elective choices have included: interventional radiology, wound care, procedure, research, Eastern medicine/acupuncture, etc…
- Variable sites – minimum 4 weeks
Self-Care
Fellows receive four weeks of paid vacation time per academic year. To help prevent burnout, we also schedule self-care events throughout the year.
- Multiple sites – longitudinal