Hospice and Palliative Medicine

Curriculum

Hospice & Palliative Medicine Educational Experience
Our curriculum is divided into thirteen blocks, each lasting four weeks. In addition to individual rotations, the fellows will have several longitudinal experiences. Fellows will have a longitudinal clinic one half-day per week seeing patients discharged from the hospital with palliative care needs, or patients referred from the community. We also offer one half-day of didactic time weekly, where fellows receive lectures on palliative care related topics. We have a weekly palliative care noon conference where the team comes together to learn from each other, as well as from outside speakers.
 
Inpatient Palliative Care Consultation Service: Four Blocks
The fellow’s Inpatient Palliative care rotation consists of managing patients with palliative care needs across various units of the hospital. Fellows will see patients in our Intensive Care Units (Surgical, Medical, Neurology, Cardiac, and Cardiovascular), Stepdown Units, Acute Care for the Elderly (ACE) Unit, and general medical floors. Fellows will be responsible for leading our Teaching Service and working with our interdisciplinary team to provide full-spectrum palliative care to our patients.
 
Inpatient and Outpatient Hospice: Four Blocks
Fellows will rotate with Dr. Aye Aung, medical director of Prisma Health Hospice for four blocks. During this time, they will become familiar with the spectrum of Hospice experiences. They will round on inpatient hospice patients across two hospitals, providing symptom management and supporting patients and their families. After inpatient rounds, fellows will see patients for Face-To-Face visits or hospice admissions in the community. Fellows will also run Interdisciplinary Team meetings (IDT) under the supervision of the medical director.
 
Pediatric Palliative Care (Inpatient and Outpatient): One Block
Two weeks of the Pediatric Palliative Care experience consist of rounding with Dr. Sharon Beall, the medical director of our fellowship-affiliated outpatient Pediatric Palliative Care group, Hands of Hope. Fellows will see pediatric patients with complex medical needs in their homes, when they are hospitalized, and sometimes at their medical appointments. The remaining two weeks are spent rounding with Dr. Robin Welsh as she sees patients across various settings from prenatal visits, to Pediatric and Neonatal Intensive Care units. During this month fellows will learn how Pediatric Palliative Care prioritizes quality of life for pediatric patients with complex medical needs.
 
Long Term Care: One Block
Fellows will rotate with a Geriatric concierge medicine practice at a local nursing home under the supervision of Dr. Victor Hirth. Fellows will round on the acute inpatient rehabilitation unit, see patients in the office and in their homes and apartments located across the grounds. Highlights of the rotation include learning to perform geriatric assessments and new admissions, as well as understanding the business aspects of concierge medicine practices.
 
Pain Management: One Half block
Pain management is a critical aspect of Palliative Care. During this rotation, fellows will spend time with an outpatient Pain Management clinic that uses pharmacologic, non-pharmacologic, and interventional pain management strategies to address pain. Fellows will also can get their Medication Assisted Treatment (MAT) training to prescribe buprenorphine if that is of interest.
 
Interventional Radiology: One Half Block
Palliative Medicine often advises patients and families about risks and benefits of procedures. During this rotation, fellows will spend time with the interventional radiologists who perform these procedures, such as port placement, dialysis access, paracentesis, thoracentesis, and imaging-guided biopsies.
 
Oncology: One Half Block
The palliative care team has a partnership with the local oncology group, South Carolina Oncology Associates (SCOA). We currently see their patients in our palliative medicine outpatient clinic and are creating an imbedded palliative medicine clinic inside of their office. Fellows will shadow the oncologists in their office to better understand their perspective on treating cancer and managing treatment-related symptoms.
 
Advanced Heart Failure: One Half Block
Prisma Health has one of the largest Left Ventricular Assist Device (LVAD) cohorts in the nation. They will round with the Advanced Heart Failure team, and learn the process of LVAD evaluation, alternatives, and complications including clotting, bleeding, and driveline infections. The palliative medicine team currently evaluates all LVAD candidates either in our clinic or in the hospital.  
 
Electives: 1 Block
Fellows have four weeks of elective time to explore areas of interest. Previous electives have included additional time with any of the established rotations, as well as working with other specialties such as infectious disease, nephrology, or pulmonology. Fellows have even created rotations at other institutions to explore their interests. Our fellowship is flexible to allow fellows to explore their areas of interest.
 
Didactics
  • Noon Conference
  • Monthly Journal Club
  • IM Grand Rounds
  • Ethics Support Group
  • Integrated Cancer Community Meeting
 
Assignments:
Fellows will be expected to present the following assignments: 2 Noon Conference, 2 Journal Club, 2 IM Grand Rounds, 2 Ethics Case and a Quality Improvement Project.