Clinical Training

Overall Program Goals

• To provide physicians the knowledge, skills, attitudes, and behaviors to integrate palliative approaches throughout the continuum of medical care and to qualify as subspecialists in palliative medicine.
• To cultivate interdisciplinary and multidisciplinary models of care for patients with advanced illness
• To foster the development of research and teaching skills to function as a clinician scientist and educator in palliative medicine.
• To create a supportive environment where professionalism, ethical principles, teamwork, and each physician’s potential are furthered.
• To promote the field through training future leaders in Hospice and Palliative Medicine

Description of Clinical Training Experiences

The one-year clinical fellowship program offers multiple block rotations with diverse experiences in inpatient palliative care consultation, home hospice and palliative care, pediatric hospice and palliative care, long term care, inpatient hospice care, and several electives.  Longitudinal clinical experiences are also stranded within a university-based palliative care clinic and community home palliative care and hospice program to provide fellows abundant opportunities to care for patients and families throughout the course of illness.  Fellows will care for patients with a broad range of diagnoses, from various socioeconomic and cultural backgrounds, and with diverse palliative care needs.  Goals and objectives of the rotation that address the 6 core competencies of the ACGME will be reviewed with the fellows prior to each clinical experience.

University of Chicago Adult Inpatient Palliative Care Consultation

Through this experience, trainees will be responsible for communicating with the primary team, running family meetings, discussing bad news, delineating goals of care near the end-of-life, advising on the care of the actively dying patient, coordinating care, transitioning care, and teaching other trainees.  The service functions as a dynamic team that represents one of the busiest and most valued inpatient consultative services at the University of Chicago Medical Center.

Pediatric Hospice and Palliative Care

This block combines inpatient pediatric palliative care consults at Advocate Children’s Hospitals in Oak Lawn and Park Ridge, and the University of Chicago Comer Children’s Hospital.

Ingalls Inpatient and Home Hospice

Ingalls Hospice is a non-profit, Medicare-certified hospice care agency located in Harvey, Illinois. The hospice has been certified by Medicare since 1990. Ingalls hospice serves approximately 50 patients at any given time, primarily in Chicago’s south side and the Chicago’s southern suburbs. Patients receive care either in their own homes, nursing homes, or through the inpatient hospice program. The inpatient hospice unit is located at University of Chicago Ingalls Memorial Hospital in Harvey. Their interdisciplinary team members include hospice physicians, RNs, LPNs, social workers, chaplains, volunteers, and bereavement counselors.

Seasons Inpatient Hospice

Seasons Hospice has a dedicated inpatient hospice unit located at Swedish Hospital. The inpatient unit provides opportunities for the fellow to aggressively manage pain and non-pain symptoms in a hospice unit, utilize resources in a cost-effective manner, and is an excellent learning environment for enhanced communication with family and caregivers to provide high-quality patient care.

NorthShore

NorthShore, part of Endeavor Health, comprised of a group of 4 community hospitals on Chicago’s north side, is another primary educational partner with University of Chicago. Glenbrook and Evanston Hospitals are the primary training sites for fellows, offering a breath of clinical experiences in consultative medicine and the Inpatient Palliative Medicine Unit. The fellows also have the option to attend outpatient clinic at the Center for Integrative Medicine.

Long-term Care and Skilled Nursing Facility

During this rotation, fellows learn the nuances of palliative care needs of the elderly, such as progression and management of neurologic illness (e.g. dementia, ALS, Parkinson’s), assessment and management of chronic non-cancer pain, wound care, geriatric syndromes (incontinence, delirium, non-cancer related functional decline, and frailty), advance care planning, and policies and regulations of long-term care settings.

Longitudinal Clinic

The University of Chicago offers multiple established longitudinal clinic experiences where fellows care for patients under the direct supervision of an attending palliative care physician on average one-half day every other week throughout the entire year (except when fellows are rotating at NorthShore).

• Oncology Palliative Care Clinic.  This clinic provides supportive care (palliative care physician, social work, nursing, nutrition, and psychologist) concurrently with oncologists.  Fellows provide supervised consultations for, and co-management of, cancer patients undergoing aggressive chemotherapeutic regimens including management of physical and psychological symptoms, quality of life interventions, and redefining goals of care.
• Specialized Oncology Care and Research in the Elderly Clinic (SOCARE).  This multidisciplinary ambulatory training model combines resources from oncology, palliative medicine, and geriatrics to provide high-quality care for older adult patients with cancer.

Electives

Fellows have two 2-week blocks (4 weeks total) protected time to explore a variety of electives including, but not limited to, Memory Disorders, Anesthesia/Pain, Psychiatry, Geriatric Frailty, HIV, Neurology, and Medical Ethics.