The core curriculum in palliative medicine is based on fellowship program certification standards developed by the American Board of Hospice and Palliative Medicine, the American Academy of Hospice and Palliative Medicine, and the Accreditation Council for Graduate Medical Education. The content of the curriculum was originally created in accordance with the Palliative Care Precepts developed in 1997 by a panel of national and international experts in palliative care and has since been modified to be in compliance with the proposed competencies of the American Board of Internal Medicine. Most recently, it has been further modified to meet the accreditation requirements set forth by the ACGME.
Fellows will demonstrate skills, knowledge, understanding, and mastery of a broad range of concepts and competencies, which include:
- Epidemiology, natural history, and treatment options for patients of all ages with common chronic, serious, and life-threatening conditions.
- History of the development of the discipline of palliative medicine.
- Age-appropriate comprehensive assessment including physical, cognitive, functional, social, psychological, and spiritual domains using data gathered from history, examination, appropriate laboratory studies, and assessment of suffering and quality of life.
- The role, function, and development of the interdisciplinary team and its component disciplines in the practice of palliative care.
- Management of common co-morbidities and complications in patients with life-threatening illness.
- Management of neuro-psychiatric co-morbidities in patients with life-threatening illnesses.
- Management of symptoms in palliative care patients including pharmacologic and non-pharmacologic modalities, and pharmacodynamics of commonly used agents. Symptom management also includes patient and family education, psychosocial and spiritual support, and appropriate referrals for other modalities such as invasive procedures.
- Management of palliative care emergencies (e.g., spinal cord compression, suicidal ideation).
- Management of psychological, social, and spiritual issues of palliative care patients and their families.
- Ability to assess the functional capability and capacity of the patient.
- The natural history, phenomenology, and management of grief and bereavement, and the role of the interdisciplinary team in providing support to bereaved family members
- Assessment and management of patients in community settings, such as home and long-term care.
- Care of the dying patient including managing terminal symptoms, patient/family education, bereavement, and organ donation.
- Economic and regulatory aspects of palliative care including national health policy issues and national financing mechanisms.
- Ethical and legal aspects of palliative care.
- Cultural aspects of palliative care including issues relating to geographic location (urban vs. rural), ethnicity, and socioeconomic status.
- Communication skills with patients, families, professional colleagues, and community groups.
- Ability to function as a consultant and demonstrate insight into one’s own limitations that justify referral to another consultant, e.g. neuroradiology, interventional pain service.
- Understanding research methodologies enabling interpretation of the medical literature and research methodologies appropriate to end-of-life care settings and populations.
- Skills in quality improvement methodologies appropriate to end-of-life care settings.
- Teaching skills relevant to the practice of palliative medicine.
- Professional self-care, e.g., self-reflection, life-long learning, balancing work and personal interests.
Brookdale Department of Geriatrics and Palliative Medicine
One Gustave L. Levy Place
New York, NY 10029-6574