Palliative Medicine – Fellowship Program

Overview

The Brown Hospice and Palliative Medicine Fellowship is offered through the Division of Geriatrics and Palliative Medicine. The one-year ACGME accredited clinical fellowship program was created in 2012 and accepts three fellows per year through the Match. Primary training sites for inpatient Palliative Care consults are Rhode Island Hospital and The Miriam Hospital, both in Providence, RI and the main teaching hospitals for the Warren Alpert Medical School of Brown University. Hospice training is based at HopeHealth, a not-for-profit hospice and palliative care organization caring for patients in Rhode Island and Massachusetts. HopeHealth is the second oldest hospice in the nation and a major affiliate of Brown.

Learn More about the Brown Hospice and Palliative Medicine Fellowship

Goals and Objectives

The goal of the Brown Hospice and Palliative Medicine Fellowship is to produce new leaders in the field who will provide and model excellent clinical care of seriously ill patients.

Graduates of the Brown Hospice and Palliative Medicine Fellowship program will be able to demonstrate the ability to:

• Deliver expert clinical care of seriously ill and dying patients in the continuum of care, including acute hospital care, ambulatory care, long-term care, and hospice in the home, nursing home and inpatient unit.
• Understand the health care delivery system relevant to terminally ill patients of all ages, including funding, regulatory issues, and how health policy is made.
• Teach and develop curriculum in all settings relevant to hospice and palliative medicine.
• Effectively understand and participate in hospice and palliative research – in basic, clinical, or health services investigations.

Duration

The training program, as specified by ACGME, is one clinically-intensive year. All fellows will have the same didactic, clinical, and research curriculum.

Prerequisite Training/Selection Criteria

Applicants must have completed or be in the process of completing an accredited residency program and be board certified or board eligible in their field. Applicants who are dedicated to the field of Hospice and Palliative Medicine from all fields are encouraged to apply.

Applications are accepted through ERAS. Applicants will be required to have a CV, 3-4 Letters of Recommendation (at least one from the Program Director or the Department Chair), a personal statement, and a USMLE transcript.

Fellowship DEI Statement

We aspire to center equity and diversity as core values in our Brown Hospice and Palliative care program. We know that having a diverse workforce that feels valued, celebrated, and supported is crucial to providing the best possible medical care for our diverse community of patients. We strive to create an environment where everyone feels comfortable and empowered to bring their full, authentic selves to work.

We also recognize that systems of oppression, including but not limited to racism, sexism, homophobia, ableism, classism, and colonialism have deeply influenced our medical system, leading to disparities in care. We are committed to mutual support and respect, difficult conversations, and collective growth toward a more inclusive world for our patients and colleagues, and work toward addressing disparities in hospice and palliative medicine.

• Hospice and Palliative Medicine Fellowship Faculty

  Jensy Stafford, MD
  Program Director

  Mara Feingold-Link, MD
  Associate Program Director

  Keith Cohen, MD
  Dana Guyer, MD FAAHPM
  Ruth Levy Guyer, PhD
  Richard Long, MD
  Rebecca MacDonell-Yilmaz, MD MPH
  Edward Martin, MD MPH FAAHPM
  Donnah Matthews, MD
  Leah McDonald, MD
  Brian Mikolasko, MD
  Christine Nevins-Herbert, MD
  Mercedes Pacheco, MD
  Timothy Poore, MD
  Gregory Rachu, MD MPH
  Jacob Ramos, MD
  Nishitha Reddy, MD
  Jennifer Ritzau, MD
  Jonathan Rose, MD
  Renée Santana, MD
  M. Catherine Trimbur, MD MPH
  Emily White, MD
  Jennifer Zuar, MD

• Core Hospice and Palliative Medicine Research Faculty

  James Rudolph, MD
  Mitchell Wice, MD

• Additional Palliative Care and Hospice Providers

  Gowri Anandarajah, MD
  Shannon Avery-Desmarais, PhD, RNP
  Mary Clare Bergen, RNP
  Christina Botelho, RNP
  Amy Buzzi, RNP
  Catherine Calandra, RNP
  Jennifer Cellar, RNP
  Tessa Centracchio, RNP
  Julie Colantuoni, RNP
  Kaitlin Collins, RNP
  Kathryn DeCarli, MD
  Sarah Rose Lamport, RNP
  Carly Masse, RNP
  Jennifer McCaskie, RNP
  Roisin McManus, RNP
  Jane McPhillips, RNP
  Peter Musso, RNP
  Carol Lee Nevulis, RNP
  Audra Noonan, RNP
  Alicia Patalano, RNP
  Ashna Rajan, MD
  Karina Santos, RNP
  Amy Sharron, RNP
  Bethany Sheahan, RNP
  Lauren Sisson, RNP
  Steven Stein, MD
  Jennifer Sweeney, RNP
  Paula Welch, RNP
  Edelva Williams, MD

• Additional Research Faculty

  David Dosa, MD MPH
  Stefan Gravenstein, MD MPH

• Sites

  • Rhode Island Hospital
  • The Miriam Hospital
  • Philip Hulitar Inpatient Center
  • HopeHealth
  • Rhode Island Hospital Cancer Center
  • Hasbro Children’s Hospital
  • Providence VA Medical Center (research)

Educational Program – Basic Curriculum

1. CLINICAL EXPERIENCE – Fellows provide direct patient care during all rotations under the supervision of a teaching attending physician.

A. Clinical components consist of the following rotations:

• Ambulatory Palliative Care: 1/2 day per week for 11 months
  • Site: Comprehensive Cancer Center at Rhode Island Hospital
• Inpatient Palliative Care: 7 months
  • Adult Palliative Care: Rhode Island Hospital (4 months), Miriam Hospital (2.5 months)
  • Pediatric Palliative Care: Hasbro Children’s Hospital (2 weeks)
• Hospice: 3 months
  • Inpatient/Home/Long Term Care
  • Chaplaincy, Bereavement, Social Work
• Elective: 4 weeks of elective of fellow’s choice. International electives can be arranged and should be pre-approved by the program director. Multiple electives can be coordinated for the 1-month block.
• Flex: 3 weeks. Fellow’s choice of inpatient consults at RIH, inpatient consults at RIH or hospice. Scheduled during the second half of the year so that fellows can tailor their fellowship experience.
• Chaplaincy: fellows will spend 1 week with inpatient hospital chaplains
• Research: 4 weeks (3 one week blocks and weekly longitudinal sessions)
• To learn more about rotation sites: https://www.brown.edu/academics/medical/about/hospitals

2. RESEARCH EXPERIENCE – Fellows have 4 weeks dedicated to completing a research project and submitting papers for publication. Fellows will have dedicated research didactics and mentoring throughout fellowship.

3. CONFERENCES, SEMINARS, TEACHING OPPORTUNITIES, AND COMMITTEE DESCRIPTIONS

A. Orientation Lectures/Workshops:
Fellows will learn basic HPM symptom management and communication skills from core faculty members. Orientation will span several days during the first week of fellowship and will also include team-building activities.

B. Arts and Ethics in Palliative Care:
Arts and Ethics is a medical humanities course that was established as a required part of the fellowship curriculum in 2018. Fellows meet twice monthly with Arts and Ethics faculty leaders to explore the intersection between the humanities, ethics, and medicine with an emphasis on serious illness, death and dying. One monthly session will be in a small group format and will focus on critical reading of texts and/or ethical case discussions. Small group sessions will conclude with shared narrative reflection. Faculty leaders are also available to provide additional feedback on content and composition of narratives. The other monthly session will feature guest speakers representing various artistic disciplines. Fellows will also attend an interactive workshop designed especially for them at the RISD Museum.
https://risdmuseum.org

C. Division Lecture Series:
This half-day weekly conference with faculty and fellows of HPM, Geriatrics and Geri-Psych will cover the principals of palliative care, geriatrics and psychiatry. It will also cover topics such as research methodology, study design, and healthcare administration.

D. Balint Group:
Hospice and palliative care clinicians meet monthly to confidentially discuss difficult cases, to support one another and to better understand the patient-clinician relationship. This group is facilitated by a certified grief counselor.

E. Palliative Care Tumor Board:
Fellows meet with palliative care faculty, medical oncology, radiation oncology, interventional oncology, psychiatry, pediatric palliative care, and PM&R twice monthly to discuss the care and treatment plans of palliative care patients.

F. Journal Club:
HPM fellows and faculty meet monthly to discuss 1-2 articles relevant to hospice and palliative care from peer-reviewed general medicine or HPM journals.

G. Inpatient Team Meeting:
Faculty and fellows will meet every Wednesday morning for reflection, case discussion, and review of a relevant journal article.

H. Research Mentorship/Dedicated Research Time:
Fellows will meet weekly to discuss projects with research faculty. Fellows have the option of joining existing research projects, working with co-fellows on a group research project, or initiating an individual research project using the VA data set. Fellows have 4 non-clinical weeks dedicated to research endeavors which can be scheduled when convenient for their projects. No prior research experience is required.

I. Opioid and Advanced Symptom Management Workshop:
Fellows will meet with program leadership weekly to participate in an opioid and advanced symptom management curriculum.

J. Inpatient Didactics:
Fellows on inpatient consult months will meet twice weekly for inpatient didactic and role play sessions covering topics relevant to inpatient palliative care.

K. Pediatric HPM Lecture Series and Additional Pediatric Opportunities
Monthly lectures by members of the pediatric interdisciplinary team exploring the medical, psychosocial, and emotional aspects of caring for seriously ill children.

Fellows will also have opportunities to participate in pediatric palliative care home visits and pediatric hospice care while on their hospice rotation. Fellows with an interest in pediatrics will have opportunities to do additional pediatric palliative care and hospice work.

L. Hospice Regulations Meeting and Board Review:
This monthly meeting covers aspects of hospice administration and the Medicare Hospice Benefit and will provide fellows with the opportunity to learn the administrative responsibilities required of hospice medical directors. These sessions end with board review questions followed by discussion.

M. Brown Minority Housestaff Association (BMHA):
Fellows are invited to become members of BMHA which aims to promote the advancement of underrepresented housestaff. Mentoring is provided through BMHA faculty, the Office of Diversity and Multicultural Affairs, and the GME Department.
https://diversity.med.brown.edu/resources-information/trainees

N. Complex Care Conversations:
This physician-led training is an intensive 1-day course during the first month of fellowship that will focus on building communication skills, as well as bioethics and prognostication. This session also seeks to explore techniques for reducing burnout and compassion fatigue.  Fellows will have an additional opportunity to participate in this course towards the end of fellowship.
https://cme-learning.brown.edu/complexcare#group-tabs-node-course-default4

O. Camp Braveheart:
Two-day summer bereavement camp held at Camp Jori in Wakefield, RI to support children (ages 4-17) who have lost a loved one. Fellows will attend a planning session and will be excused from clinical duties to work as camp counselors.
HopeHospiceRI.org/CampBraveHeart

P. SurgTalk:
In collaboration with the general surgery department, fellows will lead didactics and small group role-play with surgery residents to teach communications skills. This series of four workshops in the second half of the academic year focuses on how to teach communication skills.

Q. HopeHealth Diversity, Equity and Inclusion Committee:
Fellows are encouraged to join the HopeHealth DEI committee to improve patient access and experience of hospice and palliative care, strengthen employee education and diversification, and address workplace culture and policy. Fellows are also encouraged to participate in a DEI committee subgroup to develop targeted interventions.

R. HopeHealth Diversity, Equity and Inclusion Discussion Group:
Fellows are encouraged to participate in the monthly DEI discussion group open to all HopeHealth employees. The group discusses books, essays, movies, TED talks, etc about DEI topics and strives to facilitate discussion to promote open dialogue.

S. Bereavement Group:
The fellows will attend several bereavement groups during their hospice rotation. Bereavement groups include Loss of Spouse/Partner, Loss of Child, Loss of Parent, Children’s Grief Support, and Teen Grief Support.

T. End of Year Lecture Series:
Core faculty will teach advanced HPM topics in the second half of the academic year. Sessions will include topics such as program development and transitioning from learner to teacher.

U. Ethics Committee:
Fellows will participate in the Hospice Ethics Committee, a multidisciplinary group to discuss various ethical concerns related to hospice care. Fellows are also encouraged to join the hospital ethics committees if they are interested.

V. Department of Medicine Grand Rounds are held every Tuesday morning at RIH (also broadcast at TMH)

W. Morbidity and Mortality Conference is held every Wednesday morning at TMH

X. Schwartz Center Rounds are held several times per year at RIH, TMH and HopeHealth

Y. Additional Teaching Opportunities:
Fellows will regularly engage in teaching with Brown medical students and residents at various points throughout the year. Fellows are encouraged to partake in formal teaching (lectures, workshops) with other departments at Brown and within the medical school and can have protected time to participate in such endeavors. Fellows will also mentor students from Brown University Students for Hospice Volunteering (BUSH). Fellows will have the opportunity to partner with students from Rhode Island School of Design (RISD) to provide mentoring around palliative care for palliative care virtual reality projects.

Z. Speaking Engagements:
Fellows are expected to present an M&M, two case conference presentations, an interdisciplinary case presentation, and two journal club sessions for the Division lecture series. Fellows will also be expected to present cases and journal club articles at the weekly inpatient teaching sessions. Fellows are encouraged to submit abstracts for presentation at the AAHPM annual conference. Fellows can partake in talk review and feedback through the Program in Educational Faculty development. 
https://www.brown.edu/academics/medical/education-programs/educational-faculty-development

Interested applicants should submit an application through ERAS

https://students-residents.aamc.org/applying-fellowships-eras/applying-fellowships-eras

Those with further questions should contact:

Hospice & Palliative Medicine Fellowship
Division of Geriatrics and Palliative Medicine
Department of Medicine
The Warren Alpert Medical School of Brown University
Rhode Island Hospital
593 Eddy Street
Providence, RI 02903
Phone: 401-444-5248
Fax: 401-444-3397

E-mail:
Kimberly Chanlatte
Fellowship Coordinator
Kchanlatte1@lifespan.org

Nichole Patterson
Fellowship Coordinator
Npatterson@lifespan.org