Hospice and Palliative Medicine Fellowship

Fellow Year 1

• Inpatient Palliative Care: Consults and Palliative Care Unite (PC)5 Blocks
• Hospice: Inpatient Unit and Home Visits (Hosp)3 Blocks
• Pediatrics (Peds)1 Block
• Long Term Care (LTC)1 Block
• Advanced Pain and Heart Failure (Pain/HF)1 Block
• Oncology and Critical Care (Onc/CC)1 Block
• Elective

Much of your education will be at AdventHealth Orlando where you can experience the dilemmas of modern medicine with a dedicated team including physicians, social workers, and chaplains. You will have the opportunity to work on a consult service with disease areas ranging from cancer, dementia, heart failure, lung disease, and cirrhosis amongst others. You will also have time at the AdventHealth Winter Park campus, which provides the experience of practicing in a community hospital.

Since 1990, AdventHealth Hospice Care Central Florida (formerly known as Hospice of the Comforter) has provided end-of-life care and support to patients and their families throughout Orange, Seminole and Osceola counties. With care that is focused on comfort and quality of life, our services enable patients to live their lives to the fullest, surrounded by loved ones so that they might meet death with a sense of dignity—and so those left living may find peace and solace. AdventHealth Hospice Care’s campus is in Altamonte Springs, Florida, which includes a free-standing inpatient hospice unit with 16 private suites, as well as a 15-bed inpatient hospice unit on the campus of AdventHealth Orlando. Outside of your dedicated time with hospice you will also spend time with hospice during your Long-term Care and Pediatric experience to understand the benefits of HPM at all stages of life. You also will spend time with the home care team as well as at two of their state-of-the-art Inpatient Units, one of which is conveniently located on the Orlando Campus.

Our Palliative Care clinic includes a dynamic team of pharmacist and social worker. The clinic is currently a half day a week and is integrated throughout your work year.

We are fortunate to have Dr. Amanda Bashir help lead our Pediatric Palliative Care program. You will work along with her at the AdventHealth Children’s Hospital, housed on the Orlando Campus. There is often trepidation amongst adult physicians in dealing with sick children. We will provide a safe experience unique to each fellow’s comfort.

This rotation will focus on treating the seriously-ill in the highly regulated area of nursing homes. You will team up with the Geriatric Fellowship team. The rotation will include experiences in the Geriatric clinic and care at the Mayflower and the Gardens at DePugh, which are within 3.5miles of the Orlando campus. The Mayflower is a Continuing Care Retirement Community, which provides care ranging from independent living to skilled nursing. The Gardens at DePugh is a community SNF with a five-star CMMS rating. Part of you time will be spent from the perspective of primary physician in the NH and of the hospice team visiting the nursing home.

The AdventHealth Cancer Institute is a Center of Excellence that sees over 4,000 cases per year. You will get the opportunity to work hand in hand with the oncology team, as well as experience radiation oncology and gynecologic oncology. Palliative Care, often termed Supportive Oncology, is a crucial part in extraordinary cancer care.

You will have an opportunity to work on your own quality improvement project and submit a poster or presentation for the American Academy of Hospice and Palliative Medicine Annual Assembly. Locally you have the annual AdventHealth GME presentation day to submit to as well. This integrated research experience will utilize the established GME department’s research support team., which has been successful at winning several awards within the medicine, surgery, and radiology departments.

Unfortunately, those with substance use disorder also get serious illness. You will have the opportunity to learn best practice for safe care from our local substance use specialists. Especially during a time of an opioid epidemic and higher scrutiny, you want to have the tools to advocate for your pain patients.

You will have the opportunity to work with the AdventHealth Heart, Lung and Vascular Institute where you will understand better the patient experience and treatment options of LVAD, transplant, and ECMO through the perspective of the cardiovascular team and palliative team.

This will be integrated throughout your year and be led by bioethicist Dr. Dennis DeLeon. You will learn basic principle while applying them to real life with the ethics team as well as fascinating case studies.

• HPM Grand rounds (weekly)
• Journal Club (quarterly)
• Case Review (quarterly)
• Research Seminar (monthly)
• Physician Wellness (6 weeks)
• AdventHealth Biomedical Ethics Meeting (monthly)

Fellows will attend lectures provided by Hospice and Palliative Medicine Faculty and other physician leaders on multiple topics including:

• Pathophysiology of pain and other symptoms
• Pharmacology of analgesics
• Pharmacological and non-Pharmacological management of pain and other symptoms
• Interventional pain medicine procedures
• Hospice
• Oncology
• Cardiology
• Neurology
• Critical Care
• Geriatrics
• Pediatric Palliative Care
• Clinical Ethics
• Prognostication
• Team Dynamics in the IDT
• Communication
• Family Care
• Spiritual Care
• Withholding and withdrawing life sustaining treatment
• Grief, loss and bereavement
• Quality Measures in Palliative Care

Residents, fellows, and faculty involved in required GME scholarly activities receive guidance from the Center for Academic Research Excellence (CARE) through the Clinical Academic Research team, comprised of an Academic Research Mentor, a Project Coordinator, and a Regulatory Coordinator. In addition, the center includes a group of biostatisticians, a health economist, and a medical editor.

CARE assists residents, fellows, and faculty with all types of scholarly activities (case studies, QI projects and research studies), from study design and protocol development, to data analysis and poster, presentation or manuscript preparation.

Applicants who have completed (or will complete) an ACGME approved residency in one of the following disciplines are eligible to apply:

• Internal Medicine
• Emergency Medicine
• Family Medicine
• Anesthesiology
• Psychiatry
• Neurology
• Obstetrics and Gynecology
• Pediatrics
• Physical Medicine and Rehabilitation
• Radiation Oncology
• Surgery
• For international medical graduates, verification of Educational Commission for Foreign Medical Graduates (ECFMG) certification.
• Possess or be eligible for Florida Medical Licensure and DEA registration, along with AdventHealth Orlando Medical Staff privileges. These licensures are required before the anticipated date of matriculation.
• Be able to abide by the rules of the AdventHealth Orlando Graduate Medical Education Department and AdventHealth Orlando.
• Evidence of aptitude and interest in hospice and palliative care during residency training and/or practice with definite plans to include hospice and palliative care in the practice of medicine upon the completion of the fellowship program.
• Excellent academic and clinical performance in residency training defined on the basis of standardized examination scores and clinical evaluations.
• Excellent leadership skills demonstrated in residency training or practice.

Sample Resident Agreement

Eligibility and Selection Policy

We’ll Take Care of You

Education Allowance

Fellows will receive up to 5 days of paid leave to attend and present at conferences with CME expenses reimbursed up to $1500.

Salaries (Effective Academic Year 2022 - 2023):

PGY 4 - $63,000

PGY 5 - $65,152

PGY 6 - $68,392

PGY 7 - $71,610

Professional Fees

Florida State Medical License and DEA license fees will be covered by the program. The cost of certification classes, such as ACLS, are covered as necessary for meeting program requirements.