Fellowships

1. Harvard Palliative Medicine Fellowship

Participating Institutions:
Massachusetts General Hospital
Dana-Farber Cancer Institute
Brigham and Women’s Hospital
The Children’s Hospital
Harvard Medical School

General Information

The Harvard Palliative Medicine Fellowship is devoted to training leaders in academic Palliative Medicine. This one-year program offers a diverse clinical experience through rotations at the Massachusetts General Hospital (MGH), the Dana-Farber Cancer Institute (DFCI), the Brigham and Women’s Hospital (BWH), The Children’s Hospital (TCH), and Partners Hospice. The program is fully accredited by the American Board of Hospice and Palliative Medicine and is preparing for ACGME accreditation. The Harvard Palliative Medicine Fellows for 2007-2008.

Educational Mission

Our goal is to train physicians in the care of patients with life-threatening illness.
This is accomplished through an extensive medical, psychosocial, and communication curriculum taught by a large number of experienced and committed educators. In addition to these regular educational offerings, fellows acquire skills in the comprehensive care of a diverse patient population seen in a variety of inpatient, outpatient, and home settings.  We also offer extensive training in a pedagogical approach to teaching palliative medicine. We feel privileged to work in such a rewarding field and are eager to share this with others. Our commitment to self care is stressed through role modeling, primary mentor assignments, and a yearly day-long retreat devoted to the topic. Faculty members are committed to the professional and personal growth of each trainee.

Program Structure

The first eight weeks of the fellowship are spent either at MGH or at DFCI/BWH. The institution at which each fellow begins becomes his or her continuity site.  The continuity site is the location of the fellow’s primary mentor, outpatient continuity clinic, and psychiatric supervisor. In the remainder of the year, each fellow will spend an additional 6 months on the inpatient consult services and inpatient palliative care unit at the MGH/DFCI/BWH, 7 weeks at Partners Hospice, 4 weeks in an elective experience, and 4 weeks on vacation.

Inpatient Consult Services at Massachusetts General Hospital

Fellows spend approximately 4 months on the inpatient palliative care consult service at MGH. The Palliative Care service has been offering inpatient consultation throughout the institution since 1996.  Consults often involve assisting with goals-of-care discussions and advanced care planning, as well as providing expertise for management of distressing symptoms associated with serious/life-threatening illnesses.  While approximately over half of the patients cared for by the team have a cancer diagnosis, a substantial minority has primary cardiac, renal, pulmonary, or neurological problems without underlying cancer.  Fellows also learn to care for patients who are admitted to MGH directly through the Partners Hospice general inpatient hospice benefit.

Inpatient Consult Services at Brigham and Women’s/Dana-Farber Cancer Institute

Fellows spend an additional 4 months with the Pain and Palliative Care service at BWH/DFCI, which has been providing consultation services since 2001. Presently, the majority of consults are done for patients with cancer who often require complex symptom management during all phases of illness, from diagnosis to death.  Simultaneous attention is given to these patients’ and family members’ challenging psychosocial and spiritual concerns. The team also provides services for an increasing number of BWH inpatients with advanced life-limiting diseases other than cancer.  Many of these consults focus on goals of care, comfort for patients at the end of life, and providing support for the medical and nursing teams caring for them.  Fellows also care for patients on the Inpatient Palliative Care Unit at the BWH.

Home care and Hospice

Fellows will gain experience caring for patients in the home while completing a 7-week rotation with the Partners Hospice. During this time, fellows participate in interdisciplinary team meetings and begin to learn the skills required to be a hospice medical director.

Pediatric Palliative Care

Adult fellows spend one week with the Pediatric Advance Care Team at the Children’s Hospital of Boston to gain exposure to the care of pediatric patients. Additionally, the Children’s Hospital of Boston and the Dana-Farber Cancer Institute offer a year-long pediatric palliative care experience for those interested in further pediatric training. Please refer to their website for more information.

http://www.childrenshospital.org/clinicalservices/Site1854/mainpageS1854P0.html

APPLICATION PROCESS

Program Requirements
Applicants must meet the following criteria:
• Have completed an ACGME accredited residency program.
• Be board certified in Internal Medicine or Family Medicine or eligible with demonstration of active pursuit of board certification.

Application Requirements
1. Curriculum Vitae
2. A personal statement describing the applicant’s interest in and commitment to an academic career in palliative care.
3. Three letters of recommendation, one of which should be from the applicant’s department head, program director, or division chief.

To see a detailed 4-page document, "Overview and Expectations for the fellowship year 2007-2008," click here.

TRAINING PROGRAM LEADERSHIP   
Vicki A. Jackson, MD, MPH
Fellowship Director
Harvard Palliative Medicine
c/o Nan Lawless
Palliative Care Service
MGH - Founders 600
55 Fruit Street
Boston, MA 02114-2696
Telephone: (617) 724-9197
Fax: (617) 724-8693
E-mail: nalawless@partners.org

H. Jane deLima Thomas
Site Director
Harvard Palliative Medicine Fellowship
Pain and Palliative Care Service
Dana-Farber Cancer Institute
44 Binney Street
Boston, MA 02115
617-632-6464

(page last updated 8/8/2007)