Fellowship Training
Palliative Care


Overview
This one-year fellowship, offered under the auspices of the Department of Family Medicine, is designed to train board certified/board eligible physicians who have completed a residency training program in one of the ten ABMS/AOA specialties that support Palliative Care in the knowledge and skills necessary for a career in Palliative Medicine.

Our program is dually accredited by the Accreditation Council of Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA).

A. Clinical Learning Experiences
PC-Consult Service 7 blocks
Long Term Care/Geriatrics 1 block
Hospice 2 blocks
Pain Management Longitudinal
Pediatrics 1 block
Elective 1 block
Vacation
1 block

Inpatient Palliative Care Consultation Service (7 blocks)
Fellows rotate for 7-weeks on the JHMC Palliative Care Consultation Service. The service is made up of an interdisciplinary clinical care team that includes attending physicians, an advanced practice nurse, a social worker, chaplain, volunteers and rotating residents. Involvement from sub specialists occurs on an as needed consultative basis.

The consult service, which began in 2005, sees an average of 45 new patients per month and saw more than 400 patients over the last year. Our hospital serves an ethnically diverse community and our palliative care patients clearly represent this diversity. Clinically, forty percent of our palliative service patients have a primary diagnosis of cancer and other major diagnoses include stroke/coma, failure to thrive, end-stage lung, liver and heart disease

Long Term Care (1 block) Fellows complete a 4-week core block rotation in long term care at the Trump Pavilion

Hospice (2 blocks) Two 4-week block rotation experiences are conducted with the Hospice of New York that include inpatient and outpatient home hospice longitudinal care.

Pain Management During this longitudinal outpatient and inpatinet experience, Fellows spend concentrated time with our anesthesiologists learning about available inpatient pain management modalities

Pediatrics (1 Block) Clinical experience at St. Mary’s Hospital for Children enables the fellows to gain experience in the management of chronic complex illness in children as well as experience in Palliative End of Life and Hospice Care.

Elective (1 block) Fellows select a 4-week block elective rotation in the area of their choosing to accommodate special career development opportunities, to improve their clinical skills or to increase exposure to certain aspects of Palliative Care.

Longitudinal Outpatient Clinic Sessions Fellows conduct continuity primary care clinic sessions every week

B. Non-Clinical Learning Experiences

Journal Club: Fellows lead a monthly palliative care interdisciplinary journal club. Using clinical questions, fellows search the recent literature to choose an article from the medical literature that will influence their clinical practice.

Case Presentations: Fellows lead a monthly case-based discussion where a clinically challenging case is presented to the team and specific aspects of care are identified and focused upon by the interdisciplinary team.

Didactic Sessions: To supplement clinical learning, the fellowship includes two half-day didactic sessions per month that include didactic lectures and skill-building workshops in the key areas of Palliative Medicine. Evidence-based standards are included whenever applicable.

Weekly Interdisciplinary Team meetings: These weekly IDT meetings are held for the purpose of information sharing, administrative functions and educational activity review. Clinical issues that impact the team are discussed at these meetings as well.


Reflective Time: Fellows are encouraged to reflect on the emotional nature of their daily work through activities such as journaling, personal reading or other experiential activities. This allows the fellows to deal with topics such as personal care and balancing work and personal interests, but also gives them a free forum to experiment with methods of self-refection that they can continue to use throughout their careers.

Patient Care Logs: Fellows are required to maintain separate patient logs to document patient care experiences with hospice visits, consult service visits and long term care visits.

Research: Fellows are required to complete a scholarly project or quality improvement project during the one-year fellowship. Research participation allows fellows to integrate scholarly activities with their clinical duties and to disseminate their work through writings and/or scholarly presentations.

Teaching Experiences: Fellows are required to develop teaching skills throughout the year. These skills are developed through activities such as faculty modeling and the daily teaching of residents both informally and formally via scheduled didactic sessions.

Evaluation/Assessment

Evaluation of Fellows: Fellows are evaluated on at least a monthly basis upon completion of each block rotation.

Evaluation of Faculty: Key faculty are evaluated on at least a semi-annual basis utilizing a competency based global evaluation rating form.

Evaluation of Rotations: Fellows complete an evaluation of each block rotation experience.

Evaluation of Program: Each fellow completes an annual evaluation of the program that includes all aspects of clinical training, facilities, didactic sessions, faculty, etc.

Selected Readings

• National Consensus Project: Clinical Practice Guidelines for Quality    Palliative care
• UNIPAC series
• Fast Facts
• Journal of Palliative Medicine
• Core Textbook of Palliative Medicine of choice

Salaries and Benefits

• PGY IV Salary
   2010-2011   $ 68,502.00

House Staff Benefits
Jamaica Hospital provides all house staff residents with a comprehensive health & dental benefit plan. The Voluntary Hospitals House Staff Benefits Plan (VHHSBP) of the Committee of Interns and Residents administers the plan. Jamaica Hospital pays the entire cost of the plan whether you are single or married with children, by making premium payments to Voluntary House Staff Benefits Plan. The VHHSBP coverage begins on the first of the month following your commencement of employment, thus if you commence employment mid-month, coverage commences the first day of the following month.

The plan provides hospitalization coverage, medical, surgical and anesthesia benefits, including doctor’s office visits and well baby care. The plan also provides catastrophic coverage. If you use physicians in the VHHSBP network, your co-payment charges will be minimal. If you choose to go out of network, physicians may require co-payments. The plan also provides a comprehensive dental program.

You will be issued a descriptive booklet explaining all of your benefits. Questions should be directed to the Benefits Office at 212-725-5504.

Life Insurance
Residents are eligible to become insured under the CIR’s Group Life Insurance Program, from the date of hire, which includes double a indemnity for accidental death and dismemberment feature. Each member of the house staff is eligible for $ 100,000 of life insurance.

Supplemental Life Insurance
Jamaica Hospital Medical Center offers a supplemental life insurance program, which enables you to purchase insurance for yourself, spouse, dependent children or grandchildren. The entire cost can be deducted from your payroll.

New York State Short Term Disability
Coverage under this program provides weekly benefits following the completion of the required period of continuous total disability (seven calendar days). A house staff officer would receive New York State Disability Benefits of $170 per week would receive $80 from VHHSBP each week. Payments may continue while you are disabled for a maximum of 26 weeks.

Long Term Disability Insurance
The program is administered through the VHHSBP. The program provides monthly payments following the completion of the required period of continuous total disability (three months). The amount of monthly income payable to a disabled individual is 66 2/3 percent of basic monthly earnings up to a maximum of $1500.00 per month. Payments may continue, provided the disability continues for 60 months.

Tax Deferred Annuities
As an employee of a non-profit institution, you may have a portion of your salary deducted and deposited directly into one of several tax deferred annuity programs that the hospital participates. No taxes except F.I.C.A., would be taken out of these funds. You can enjoy the benefit of lower taxes by deferring part of your gross salary. The funds are subjected to taxes upon withdrawal and may be subjected to withdrawal penalties before age 59 1⁄2. These funds will earn market based returns meant for your retirement or catastrophic needs. Additional information can be obtained from the Human Resources Department.

Additional Benefits
* Discount Parking
* Vacation
* 12 Paid Sick Days (per year)
* Paid Holidays
* 4 Personal Days (per year)
* Complete Malpractice Coverage
* Full Rx Drug Coverage

Application
To apply to our fellowship or for further inquiries, please call
(718) 206-6919 or email: lsalery@jhmc.org


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