Our core curriculum follows the 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. We also comply with the proposed competencies of the American Board of Internal Medicine.
As a fellow, you spend approximately half of your time (12 months) in our Outpatient Palliative Medicine Continuity Clinic, divided into weekly four-hour sessions. You care for a panel of patients; you see them in the outpatient setting, coordinate their care with social work and other medical specialties, and work with their families.
In addition, you work in the following areas:
- The Mount Sinai Health System Palliative Care Consult Service (5 months)
About a third of these patients have a primary diagnosis of cancer. The rest have primary diagnoses of heart disease; stroke or coma; dementia; end-stage lung, liver, or renal disease; or AIDS. The interdisciplinary team caring for these patients includes specialists in geriatrics, palliative medicine, oncology, medicine, psychiatry, and neurology.
- James J. Peters Veterans Administration Medical Center Palliative Care (2 months)
You take primary responsibility for patients in the supportive care unit, the inpatient consult service, and the outpatient clinic, providing experience in long-term care and inpatient hospice.
- The Mount Sinai Visiting Doctors Program (1 month)
You serve frail, chronically ill, and homebound patients throughout Manhattan. You learn about family and patient needs assessment in the home, the nature and availability of funded and unfunded support services in homecare settings, and the experience of living with and caring for serious illness outside of health care institutions. Most of these patients are not enrolled in hospice.
- Visiting Nurse Service of New York Home Hospice Care (1 month)
We care for patients living throughout New York City with all types of illnesses, including cerebrovascular disease, diabetes, congestive heart failure, hypertension, cancer, and AIDS. Through this program, you work with patients in their own homes and inpatient settings.
- Calvary Hospital (1 month)
As the only fully accredited acute care specialty hospital in the United States devoted exclusively to providing palliative care to adult advanced cancer patients, we help patients live as fully and comfortably as possible until life ends. We focus not only on relief of physical pain, but working to alleviate emotional, spiritual, and psychological suffering. We work closely with the patient’s family.
- Interventional Pain (2 weeks)
Run by the Department of Anesthesia, our service exposes fellows to pain management techniques including acupuncture; injection procedures such as spinal, epidural, nerve root, joint, and botulinum toxin injections; and implanted devices such as stimulators and intrathecal pumps.
- Pediatric Palliative Care (2 weeks)
Committed to medically fragile children, we offer team-based trans-disciplinary care including medicine, nursing, social services, palliative care, mental health, rehabilitation, education, nutrition, child life and therapeutic activities, and pastoral care.
- Elective Rotation (2 weeks)
You can select a two-week elective rotation in the area most appropriate to your interests and goals.
As a fellow, you learn from a range of non-clinical learning experiences:
- Palliative Medicine Journal Club
Fellows lead the monthly interdisciplinary palliative medicine journal club, under supervision of a faculty member.
- Didactic Lectures
We address symptom management, functioning as a consultant, grief and bereavement, spiritual assessment, communication skills, pediatric palliative care, and cultural aspects of palliative care.
- Monthly Fellows Meetings
All fellows meet monthly to discuss the fellowship, reflect on the emotional nature of the work, and offer suggestions for improvement.
- Bereavement Sessions
Facilitated by a certified grief therapist, these every-other-month sessions offer a "safe space" to reflect on the loss of a particular patient or address the feelings engendered by the complex nature of our work and its relationship to loss.
- Weekly Palliative Care Meetings
Every week, you join the staff of the Hertzberg Palliative Care Institute to discuss clinical issues through clinical interdisciplinary conferences, clinical staff meetings, administrative conferences, and palliative care continuing education meetings.
- Thursday Academic Half-Day
Once a week, we excuse all fellows from clinical duties to participate in didactic and small group teaching sessions facilitated by both leading geriatric faculty as well as fellows. Topics include dementia, delirium, constipation, incontinence, and preventing falls. Small group teaching includes the geriatrics journal club and a monthly morbidity and mortality conference led by fellows. During this time, you can also participate in the Master Geriatric Educator Program, a certificate course to develop expert educators in geriatric medicine and other disciplines. This program covers teaching principles and skills, curriculum development, and evaluation and assessment techniques.
- Medical Student Teaching
Each month, you offer didactic lectures to third-year medical students about palliative care. You also provide informal teaching during the medical students’ week on the palliative care service.
- Palliative Care Grand Rounds
These teaching conferences focus on a critical review of the palliative care literature and academic research presentations by regional and national leaders in the field of palliative care. We also encourage you to attend geriatrics Grand Rounds.
Palliative Care Service Rotation
Palliative care is important to us, and we make sure that all the students at the Icahn School of Medicine at Mount Sinai gains some experience learning about this area:
- Third-year medical students spend one week on the palliative care service.
- Geriatrics and hematology/oncology fellows spend at least four months on this service.
- Fourth year medical students and house staff can elect participate on our service for an additional rotation.
We administer a short, multiple-choice test at the beginning and end of the rotation to give you a sense of what you want to learn and then to assess whether you did so.