The mission of the UT Southwestern Medical Center Hospice and Palliative Medicine Fellowship Program is to educate physicians to provide patients with life-limiting illness and their families with the best possible care using expertise in clinical skills and an excellent fund of knowledge based on current clinical and basic science research.
The Hospice and Palliative Medicine Fellowship is based in the General Internal Medicine Division of the Department of Internal Medicine at UT Southwestern Medical Center and affiliated hospitals (Dallas Veterans Affairs Medical Center, Parkland Memorial Hospital, and Children’s Medical Center Dallas). The program encompasses acute, ambulatory, community, and long-term care experiences.
Overall Goals and Objectives
The overall goals and objectives for hospice and palliative medicine fellows are to gain extensive experience in the diagnosis and ongoing management of elderly patients with multiple medical problems across a variety of health care settings. These goals and objectives are primarily aimed at gaining experience in the daily management and provision of continuity care to patients with life-limiting illnesses, paying particular attention to pain and symptom management.
In general the expectations of fellows include demonstration of medical knowledge, comprehension of pathophysiology, development of differential diagnoses, formulation of management plans, and dissemination of plan of care by presentations in various clinical settings and at clinical conferences.
Candidates for UT Southwestern Hospice and Palliative Medicine Fellowship Program must have completed medical training, including medical school, internship, and residency, in the United States. Only J1 visas will be considered.
Fellows are taught how to deliver high-quality care that is compassionate, appropriate and effective.
Proficiency in this competency includes knowledge of biomedical, clinical, and epidemiological domains. Individual fellows will be taught and evaluated based on their ability to acquire and access new knowledge, interpretation of information, and then how to apply this information to clinical settings, specifically the individual patient.
Interpersonal and Communication Skills
This competency domain contains two areas – communication skills, and interpersonal skills. Communication skills include effective verbal, nonverbal, and written communication with patients, interdisciplinary team members, and the public. Interpersonal skills involve teamwork and relationship-building skills. Effective communication creates and sustains a professional and therapeutic relationship across a broad range of socioeconomic and cultural backgrounds.
Practice-Based Learning and Improvement
Life-long learning and quality improvement is at the core of this competency domain. Fellows are trained to engage in Plan-Do-Study-Act (PDSA) cycles for quality improvement in their individual practice. The skills and practice of evidence-based medicine is incorporated.
Proficiency in this competency is integral to the other competencies. Fellows must demonstrate an adherence to ethical principles. They must make a commitment to their professional responsibilities and demonstrate sensitivity to their patients and the interdisciplinary team members.
This competency domain recognizes the multiple layers within the health care system. It includes the user – patient and families; the purchaser – employers, government; insurers – Medicare, Medicaid, commercial; delivery systems – hospitals, physician networks, drug and technology companies, community resources; work group – local entities providing care such as hospitalist service; and providers – physicians, nurses, and other health care professionals as individuals or groups/team.
Overview of Clinical Activities and Responsibilities
The Hospice and Palliative Medicine Fellowship Program curriculum has been specifically designed to ensure that each fellow has the opportunity to achieve the knowledge, professional attitudes, and practical experience required of a physician caring for the elderly patient. Each fellow will participate in and will be closely supervised by trained faculty in the clinical activities described below. Each portion of the fellowship has clearly defined expectations, objectives, and goals.
Both the preceptor and the fellow are expected to complete timely written evaluations. As peer interaction is essential for the fellows, each fellow will gain experience teaching nurses, allied health personnel, medical students, and residents both in a structured and in an informal way.
Overview of Scholarly Activities
In addition to direct patient care responsibilities in a variety of clinical settings, the fellow will be provided with a variety of didactic lectures and learning experiences. Extensive library materials and services are available to the fellow at UT Southwestern Medical Center, Parkland Memorial Hospital, and the Dallas Veterans Affairs Medical Center.
Attendance at National Meetings
One week of educational leave is provided for the fellow to attend at least one national meeting (i.e., Academy of Hospice and Palliative Medicine, ASCO). Any prospective meeting plans must be discussed in detail with the program director in advance. $1,000 is available per fellow for participation in a national meeting of their choice.
Fellows will participate in the annual research training day offered by theClinical and Translational Research Center at UT Southwestern. The CTRC is a clinical research unit that provides services to the faculty and staff of UT Southwestern and other partners in the North and Central Texas Clinical and Translational Science Initiative (NCTCTSI). The CTRC is comprised of an outpatient facility and an inpatient unit dedicated to supporting clinical research. The training day will cover essential principles of clinical research. At the conclusion of the even, the fellow will receive a Best Research Practices certificate.
Quality Improvement Project
The fellow will spend two months working on the Parkland Palliative Care Consultation Service. Half-way through the first month they will meet again to formulate a clinical question and design a study to help answer it. Prior to the second month on service, the fellow will collect baseline data, and, if possible, implement interventions based on the findings. During the second month, if not before, data regarding the intervention will be collected and analyzed.
About UT Southwestern Medical Center
UT Southwestern Medical Center, Dept of Physical Medicine and Rehabilitation, Dallas, TX