Embedded in the Hospice and Palliative Medicine Fellowship are longitudinal didactics, which provide a fundamental knowledge base for the clinical practice of palliative care and focus on research skills relevant to palliative care.

• Principles and Practice of Palliative Care – This course provides fellows with a thorough introduction to the evidence base and skill set needed for the clinical practice of palliative care. This clinical knowledge base not only prepares fellows for their clinical work in palliative care but also guides and informs their choice of a research interest. The course meets for one hour each week July through March.

• Teaching Communication Skills – Over the past 10 years, studies have provided increasing data regarding the efficacy of educational interventions to improve physician communication skills. This course ensures that medical educators have the practical skills needed to design and teach communication courses with simulated patients and teach communication skills in real time in the clinical setting. This course occurs 6 hours a week for 6 weeks in late fall/early winter.

• Didactic Thursday – This educational series occurs twice a month for 2 hours and includes a wide variety of topics including early communication skills, case-based ethics discussions, reflective reading and writing, mindfulness training, music therapy, dignity therapy, social justice, navigation of legal matters, and career advisement, and open case discussion.

• Communication Skills – Fellows receive a rigorous and comprehensive communication training in various settings. A summer intensive communication series occurs in Didactic Thursday which introduces the fundamentals of our communication mental model.  The fellows also receive sessions in the important skills of Motivational Interviewing by highly trained palliative care faculty.  Importantly, fellows attend a three-day intensive communication retreat (Pallitalk) with palliative medicine and geriatric fellows from the region, during which they practice their own communication skills. Following completion of the retreat, fellows participate in a series of sessions involving professional-simulated patients, facilitated by faculty with extensive expertise in communication skills training focused on difficult communication tasks such as responding to a request for hastened death, discussing opioid misuse, and disclosing medical errors.

• Well-Being Curriculum – In order to provide a comprehensive fellowship training that lays the foundation of a long and fulfilling career in Palliative Care, we strongly believe that our fellows need to develop sustainable skills in coping and resiliency.  We have created a Well-Being curriculum that supports our fellows as both a bonded group and as individuals. This includes a monthly process group, a robust mentorship program, reflective reading and writing sessions, mindfulness-based self-care, and a 4-session museum-based education (MBE) curriculum in partnership with the Carnegie Museum of Art. The MBE curriculum focuses on such areas as perspective-taking, the culture of medical training, sitting with our own difficult emotions, and building skills in resiliency such as self-compassion, meaning, connection, and gratitude.

Fellows in the two-year program can choose additional elective courses, based on their individual interests and planned research program. Electives that suit the individual fellow’s goals can be selected from courses offered by the ICRE, as well as from other locations, including the Center for Bioethics and Health Law, the Graduate School of Public Health, the School of Social Work, and the School of Nursing.

• Quality Improvement and Patient Safety Project – All fellows complete a quality improvement project. Fellows work together as a group and are able to choose from a variety of quality improvement projects that are ongoing within the Section of Palliative Care and Medical Ethics. Fellows work with faculty mentors as well as quality improvement experts to help investigate and address quality improvement issues encountered in the inpatient, ambulatory, or hospice setting.

• Root Cause Analysis Case Presentation – Fellows will become familiar with the process of RCA through a dedicated curriculum within Didactic Thursday. In 5 short sessions throughout the year, fellows will work through choosing a case, creating fishbone diagrams, identifying stakeholders, and brainstorming recommended actions . These sessions are facilitated by physician faculty experienced in patient safety and quality improvement. The mini-series approach will allow fellows to start to incorporate this type of critical thinking into their daily practice.

• Research/Education Project – Fellows in the two-year program will complete a research/education project during their fellowship. To help in this process and with career counseling, each fellow will select at least one primary research or education mentor whose experience and interests complement theirs. A diverse group of experienced mentors from multiple departments has been assembled to encourage the development of an effective mentoring relationship. The group includes funded researchers in the departments of medicine, psychiatry, and critical care medicine, as well as researchers at the University of Pittsburgh Cancer Institute.

• Case of the Month – All fellows contribute to this monthly publication and collaborative effort between the Palliative and Supportive Institute and the University of Pittsburgh Palliative Care faculty members. In addition to being distributed through the Pitt/UPMC community, the Case of the Month articles are posted on Pallimed: Arts & Humanities, a blog focusing on the many themes in palliative medicine that intersect with film, music, paintings, books, and other artistic media.

Depending on their level of interest, fellows also have the opportunity to work on smaller projects, such as “Fast Facts,” article reviews, or presentations at local or national meetings.

Post-residency physician fellows must meet the following criteria:

• Have completed an ACGME or AOA-accredited residency program in anesthesiology, emergency medicine, family medicine, internal medicine, neurology, obstetrics and gynecology, pediatrics, physical medicine and rehabilitation, psychiatry, radiation oncology, or surgery
• Be board-certified or board-eligible with demonstration of active pursuit of certification
• Demonstrate interest in pursuing an academic career with palliative care as a primary focus

Fellowship applicants submit applications through the Electronic Residency Application Service (ERAS). Of note, the specialty of Hospice and Palliative Medicine participates in the match process. Applications will be accepted through ERAS the summer prior to fellowship start. Please contact us directly if you have any questions about the application process.

All completed applications will include:

• A personal statement (a statement of the applicant’s interest in and commitment to an academic career in palliative care)
• At least three letters of support, one of which should be from the applicant’s department head, program director, or division chief
• Scores from USMLE Step 1, 2, and 3 or COMLEX Level 1, 2, and 3
• A curriculum vitae
• Medical school transcripts
• MSPE

For more information, contact:

Ethan Silverman, MD
Assistant Professor of Medicine
Program Director, Hospice and Palliative Medicine Fellowship
Section of Palliative Care and Medical Ethics
Montefiore 933W
200 Lothrop Street
Pittsburgh, PA 15213
E-mail: silvermanej@upmc.edu

Alyssa Bernens
UPMC Montefiore Hospital Suite N715
200 Lothrop Street
Pittsburgh, PA 15213
Phone: 412-683-7647
Fax: 412-692-4944
E-mail: bernensa@upmc.edu