The AdventHealth Palliative Medicine APP Fellowship

Our program goals include:

• Gather, synthesize and apply comprehensive and accurate clinical information from all sources pertaining to the medical care of outpatient/inpatient palliative care patients
• Recognize the presentation, management, disease trajectories and various treatment modalities (chemotherapy, hormonal therapy, immunotherapy, surgery, radiation) for common solid and hematologic malignancies
• Develop competence in pain management for cancer and non-cancer pain for outpatient/inpatient palliative care patients, with a focus on safe opioid prescribing (checking PDMPs, obtaining prior authorizations, documenting prescription refills, fielding other patient requests), monitoring opioid risk scores, screening for substance use disorder and current substance use/misuse, and non-opioid analgesics, adjuvant analgesics and non-pharmacologic approaches
• Develop competency in assessment and management of common non-pain symptoms for palliative care outpatients/inpatients, including, but not limited to:
  • Nausea and vomiting (chemo-induced, malignant obstructions, other causes pertinent to cancer)
  • Dyspnea
  • Insomnia
  • Fatigue
  • Depression and anxiety
  • Existential suffering and grief
  • Anorexia/weight loss
• Demonstrate knowledge of alternate routes of administration for medications when patients are unable to take medications orally
• Develop skills in working with an IDT in all aspects of patient care
• Develop skills in communicating/collaborating with oncology providers (hematology/medical oncology, surgical/gynecologic oncology) and other providers (primary care, surgeons, other specialists) while patients are going through cancer treatment
• Demonstrate accurate and comprehensive understanding of psychological stressors and disorders experienced by patients and families facing life-threatening conditions and describe appropriate clinical assessment and management, including the ability to assess, counsel and support patients and families around the burdens of caregiving and make appropriate referrals around fiscal issues and legal concerns

Our program goals also include:

• Demonstrate knowledge of local laws and regulations related to the following areas: medical marijuana, physician aid in dying and opioid agonist therapy for opioid use disorder (methadone and buprenorphine)
• Determine relevant scholarly questions and pursue relevant scientific inquiry, particularly regarding topics in outpatient palliative care and supportive oncology
• Effectively communicate across care settings (outpatient, inpatient, hospice) for patients receiving palliative care and demonstrate knowledge of the transitions between these care settings
• Develop competence in discussing end-of-life care in the outpatient/home setting
• Gain experience in related specialties to outpatient palliative care, such as physical medicine and rehabilitation, hematology/medical oncology, gynecologic oncology, radiation oncology and wound care
• Demonstrate care that is respectful of age, developmental stage, gender, sexual orientation and cultural practices
• Maintain a safe and competent practice, including self-evaluation and continuous learning
• Maintain comprehensive, timely and legible medical records
• Demonstrate care that is cost-effective and represents best practices
• Demonstrate the capacity to reflect on personal attitudes, values, strengths, vulnerabilities and experiences to optimize personal wellness and capacity to meet the needs of patients and caregivers

In our fellowship program, rotations include:

• Inpatient Palliative Care - Core
• Outpatient Palliative Care - Core
• Oncology - Core
• Pulmonary Hypertension - Core
• Intensive Care Unit - Core
• Heart Failure - Core
• Chaplaincy - Core
• Inpatient Hospice - Elective
• Outpatient Hospice - Elective
• Music Therapy/Child Life Therapy - Elective
• Elective of Choice - Inpatient Palliative Care, Outpatient Palliative Care, Oncology, Pulmonary Hypertension, Music Therapy/Child Life Therapy, Heart Failure, Chaplaincy, Intensive Care Unit, Inpatient Hospice, Outpatient Hospice, Research, Leadership/Administrative

We want to ensure that it’s rewarding for you to expand your expertise with us. We have made these benefits part of our fellowship program:

• Salary of $70,000 for the duration of the fellowship
• Professional liability coverage
• 21 paid leave days for the duration of the fellowship year, which includes holidays, vacation, sick leave or other personal time off
• Medical insurance
• Life insurance
• Disability insurance
• Retirement plan

Every rotation fellow will be assigned an SDCP preceptor to help reach their block learning objectives. Palliative Care is supported by an interprofessional team, including Nurse Practitioners, Licensed Clinical Social Workers, Nurses, Physicians and Chaplains. Fellows have mentorship opportunities from any member of the team.

At the completion of the fellowship, the APPs will be well-prepared to begin their palliative medicine careers and, if applicable, be ready to sit for the ACHPN examination. Fellows will receive a certification of program completion. Full-time employment offers are contingent upon position availability and performance review.

Candidates will be notified if invited for an interview. The interview day will consist of program orientation, committee interview, individual interview and a tour of the AdventHealth Orlando campus.

The interview committee is composed of APPs, physicians and leadership in Palliative Care. The committee will be considering these core competencies:

• Interpersonal communication skills
• Professionalism
• Medical knowledge
• Patient-care experience
• Empathy
• Resilience
• Growth mindset

It is the candidate's responsibility to arrange travel and lodging for the interview day.