Section of Palliative Care and Medical Ethics

Hospice and Palliative Medicine Fellowship

TESTIMONIALS

UPMC GME HOSPITAL TOUR

UPMC GME PROGRAM OVERVIEW

WELL-BEING CURRICULUM

PEDIATRIC TRACK

COMMUNICATION

FACULTY COMMITMENT

MENTORSHIP

PITTSBURGH

CHILDREN’S HOSPITAL TOUR

The University of Pittsburgh’s Fellowship in Hospice and Palliative Medicine offers three options:

 

  • A one-year clinical fellowship offered by the Section of Palliative Care and Medical Ethics and accredited by the Accreditation Council for Graduate Medical Education (ACGME) that includes a high-volume, interdisciplinary clinical program
    • A one-year pediatric-track clinical fellowship offered by the Section of Palliative Care and Medical Ethics in conjunction with the Division of Palliative Medicine and Supportive Care at UPMC Children’s Hospital of Pittsburgh and accredited by the Accreditation Council for Graduate Medical Education (ACGME) that includes a high-volume, interdisciplinary clinical program
      • A two-year fellowship option that extends beyond the clinical year to prepare individuals for an academic career in the growing specialty of palliative medicine, enabling fellows to earn a master’s degree either in medical education or clinical research
      Program Structure

      The Hospice and Palliative Medicine Fellowship provides fellows a rigorous and clinically intense training experience that will prepare them for a successful palliative medicine career in the ambulatory, hospice, hospital, or academic setting. In addition to teaching symptom assessment and management in a wide variety of disease processes, we have developed a rigorous and highly regarded communication curriculum that equips fellows to excel in their communication with patients, families, and other health care providers. The one-year fellowship program has been fully accredited through the ACGME.

       For fellows who want to pursue further training for a career in academic palliative medicine—either as a clinical investigator or educator—we offer an elective second year. The two-year program combines the palliative medicine program’s own research and educational resources with the opportunities offered by the Institute for Clinical Research Education (ICRE) degree programs in clinical research and medical education at the University of Pittsburgh. These programs provide fellows with didactic training in a broad spectrum of research and educational methodologies, technologies, and tools; exposure to multidisciplinary research and educational teams; hands-on mentored experience in conducting patient-oriented research; and the conceptual and writing skills necessary to submit competitive grant applications for successful, long-term patient-oriented research or education careers. By the end of the second year, fellows will obtain a master’s degree from the University of Pittsburgh in clinical research or medical education, with a special focus on palliative care.

      We also offer a separate fellowship track in pediatric palliative care.

      Training Sites
      UPMC Presbyterian Hospital; Level I Regional Resource Trauma Center and a renowned quarternary center for organ transplantation. UPMC Shadyside Hospital is a nationally ranked tertiary care hospital specializing in medical and surgical oncology care.
      UPMC Mercy Hospital is home to the UPMC Rehabilitation Institute’s Centers of Excellence in stroke rehabilitation, spinal cord injury, and brain injury. UPMC Children’s Hospital of Pittsburgh is a nationally ranked in all 10 pediatric subspecialties surveyed by US News & World Report.  It is also recognized as a top pediatric hospital for innovation and technology and has been praised as one of the nation’s most creatively beautiful hospitals.
      Hillman Cancer Center is the region’s only comprehensive cancer center designated by the National Cancer Institute. Family Hospice is the leading not-for-profit, community-based hospice organization in the region. It’s 12-bed inpatient unit is housed within UPMC Canterbury nursing facility.

       

      Adult Fellowship Clinical Program
      The clinical focus of the fellowship is on acquiring skills in providing comprehensive care to patients with life-limiting illnesses in acute care, ambulatory care, home care, and long-term care settings. Fellows will spend substantial time in each of these settings and will follow patients longitudinally as they move between different settings. The role of the physician as a member of an interdisciplinary care team will be emphasized in all clinical settings and encounters. The individual aspects of the clinical program are:

      • Inpatient Palliative Care Consultation Service – Fellows spend 2 months each at UPMC Presbyterian-Montefiore Hospitals, UPMC Shadyside Hospital, and UPMC Mercy hospital, for a total of six months in the inpatient setting. Adult medicine fellows also spend at least two weeks on the inpatient supportive care consult service at Children’s Hospital of Pittsburgh.
      • Home Care and Hospice – Fellows will gain extensive experience managing home care and hospice patients through time spent with Family Hospice and Palliative Care, the largest hospice program in western Pennsylvania. Fellows will spend 10 weeks within the hospice setting with a flexible structure between inpatient and home hospice depending on educational value and patient need. The first 4 weeks will be primarily at the inpatient unit with dedicated 1:1 teaching by the academic hospice attending. During this time, fellows will be allowed to perform home hospice visits when this provides educational value or patient continuity.  The second 4 weeks will be primarily home hospice visits. The fellows will be encouraged to make visits with various members of the interdisciplinary team and also to make independent visits. If there is educational value in spending additional time at the inpatient unit, fellows will be encouraged to do so. Fellows may also have teaching opportunities with residents and medical students during the second 4-week block. The remaining 2 weeks will be dedicated to a bereavement and spiritual care experience within the hospice setting and will be facilitated by the hospice bereavement and chaplaincy staff.
      • Long-Term Care – Fellows will receive 1 month of a long-term care experience. This includes rounding at a UPMC nursing facility with 1:1 teaching with a geriatrician. It may also include wound care, geriatric psychiatry, and outpatient programs such as the Advanced Illness Care Program and Community Life.  These programs focus on holistic care for elderly adults and keeping them healthy and at home.
      • Outpatient Clinic – Fellows will maintain their own outpatient clinic practice of one half-day a week under the supervision of palliative care faculty.  The primary site is Hillman Cancer Center Pain and Supportive Care Clinic. As part of a multidisciplinary team, fellows will manage patients at all disease stages with multiple physical, psychosocial, spiritual, and existential issues. Fellows will follow new patients longitudinally in the ambulatory setting as well as across settings if patients are admitted to the hospital or go to hospice.
      • Elective and Supplemental Clinical Experiences – Fellows will spend 2 months on clinical elective experiences.  Many formal elective experiences are available.  Most notably among these is a non-malignant palliative care experience which includes time spent in dedicated renal, cardiac, and pulmonary palliative care clinics as well as some time spend in relevant areas of neurology such as Multiple Sclerosis and Huntington’s Disease.  A robust elective experience in Behavioral Medicine is also offered. Additional electives are available in ethics, addiction medicine, integrative medicine, geriatrics, chronic pain, pediatrics, liver transplantation, critical care, cardiology, and pulmonary care and can easily be arranged in other areas of special interest.
      • Other Experiences – Fellows attend all the relevant ongoing teaching conferences, including Journal Club (in which they present biannually), Psychosocial Conference, Fellows’ Process group, and Palliative Care Grand Rounds.
      Structured Didactics

      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 from September 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 for 3 hours/week for 6 weeks in October and November.
      • Chief’s Rounds – This educational series meets weekly for one hour 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 Chief Rounds 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.

      Pediatric Track

      A one-year pediatric focused clinical fellowship is offered to applicants preparing for an academic and/or clinical career in pediatric hospice and palliative medicine.  Fellows in this track will receive rigorous training in pediatric palliative care with a focus on pain and symptom management, decision making support, care coordination, end-of-life and hospice care, and bereavement care for children and young adults with life-threatening and life limiting illness.  This fellowship program is fully accredited by the ACGME, and graduates will be board eligible for Hospice and Palliative Medicine via their primary boarding organization. 

      The inpatient pediatric experience is hosted by UPMC Children’s Hospital of Pittsburgh, a premier pediatric institution which is nationally ranked as a top 10 children’s hospital by US News and World Report.  Established in 2003, the palliative care program at UPMC Children’s Hospital of Pittsburgh is consulted by multiple services including: oncology, neonatology, cardiology, hospital medicine, critical care medicine, cardiac transplant, gastrointestinal transplant, neurosurgery, and cardiac critical care medicine.  A continuity clinic is offered in conjunction with the complex care clinic which cares for children who have complex medical issues.  The program has 3 full time faculty members, a nursing manager, 3 advanced practice providers, a social worker, a bereavement coordinator, and a sibling bereavement coordinator.

      Pediatric based electives include perinatal palliative care, music therapy, art therapy, child life, bereavement care, sibling bereavement camp, pediatric physical medicine & rehabilitation service (inpatient or outpatient), outpatient complex care clinic, and pediatric neurology consult service.  The pediatric team is also willing to design electives to meet the needs of our fellows.

      Pediatric fellows will participate in the same structured didactics, scholarly activities, and other learning opportunities as adult fellows. Fellows also have access to both adult and pediatric faculty who have won numerous awards for both clinical care and teaching.

      Notably, applicants who have trained in pediatrics may apply to the pediatric track, the traditional fellowship track, or both.

      Pediatric Faculty:

      Scholarly Activities
      • 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 Chief Rounds. 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.

      Academic Environment

      The fellowship program is housed in the Section of Palliative Care and Medical Ethics within the Division of General Internal Medicine and the Department of Medicine. Our active research program has been successful in obtaining millions of dollars in grant support and have collaborative relationships with educators and researchers in oncology, ethics, anesthesia, and geriatrics.

      Fellows

      First Year Fellows

      Alexander Ginsburg

      Medical School: Mayo Clinic Alix School of Medicine
      Residency: Mayo Clinic School of Graduate Medical Education

      Alex Ginsburg is a first-year fellow in the Hospice and Palliative Medicine Fellowship. Dr. Ginsburg grew up in Chicago and received a B.A. in Religious Studies Summa Cum Laude from Arizona State University and masters degrees in Geography and Community & Regional Planning from the University of Oregon. He subsequently graduated from the Mayo Clinic School of Medicine. He remained at Mayo Clinic for residency in Emergency Medicine where he served as Chief Resident. His interests include integrating palliative medicine into the Emergency Department, goals of care discussions with the critically ill, pain management, and teaching communication skills to Emergency Medicine residents. Outside of medicine, Dr. Ginsburg enjoys spending time with his wife and two sons, hiking, rock climbing, and cooking.

      Samuel Hand

      Medical School: University of Alabama School of Medicine
      Residency: UPMC Internal Medicine Residency Program, Global Health and Underserved Populations Track

      Dr. Hand is a first-year fellow in the Hospice and Palliative Medicine Fellowship of UPMC. In 2014, he graduated summa cum laude with a B.S. in French and Biology from the University of Alabama; he received his M.D. from the University of Alabama School of Medicine before making his way to Pittsburgh for residency in 2018. Dr. Hand completed his residency at UPMC in Internal Medicine as part of the Global Health and Underserved Populations Track in 2021. His interests include medical humanities, narrative medicine, and underserved medicine. He enjoys spending time with his spouse, Ashlea, and his sons Benjamin and Theodore, making the most of small, everyday joys like cooking, reading, biking, family dance parties, hiking, and playing board games.

      Katherine Hill

      Medical School: University of Pittsburgh School of Medicine
      Residency: University of Pittsburgh Medical Center

      Dr. Hill is a first-year fellow in the Hospice and Palliative Medicine Fellowship. Dr. Hill grew up outside of Pittsburgh, PA. She graduated summa cum laude with a B.S. in Molecular Biology and a minor in Mathematics from Grove City College in 2009, and received her M.D. from the University of Pittsburgh School of Medicine in 2013. She completed residency in General Surgery at UPMC in 2021, and also completed an M.S. in Medical Education during residency, through the University of Pittsburgh School of Medicine. She lived and worked at Tenwek Hospital in Bomet, Kenya for a year in 2018, where she was involved in surgical residency as well as curricular development for COSECSA (the College of Surgeons of East, Central, and Southern Africa). In addition to global surgical education, her professional interests include enhancing communication skills for surgical trainees. Outside of medicine, she spends time with her husband, Chris, and daughter, Ruth, and enjoys liturgical choral music as a member of the Pittsburgh Compline Choir.

      Kate Ostrander

      Medical School: Tufts University School of Medicine
      Residency: University of Vermont Children’s Hospital, Department of Pediatrics

      Kate Ostrander is a first-year fellow in the Hospice and Palliative Medicine Fellowship, pediatric track. Kate is originally from Geneva, NY. She graduated summa cum laude with a B.S. in Public Health / Health Science from Northeastern University in 2011, having done co-op programs at Dana-Farber’s Survivorship Clinic and at Littelfield Home Orphanage in Malawi. She received her M.D. with research honors in 2016 from Tufts University, where she participated in a rural, longitudinal clinical track in central Maine and did her research concentration program at the Maine Center for Outcomes Research. She completed pediatrics residency at the University of Vermont in 2019 and has since worked as pediatric hospitalist at their Children’s Hospital. Her academic interests include teaching serious illness communication, provider wellness and de-briefing, and service-learning in medical education. She enjoys outdoor activities in all seasons with her daughter and husband, Dan (an incoming pediatric ENT fellow at UPMC) and experiencing live music.

      Grace N. Slater

      Medical School: University of Illinois College of Medicine – Peoria
      Residency: UPMC Children’s Hospital of Pittsburgh

      Dr. Slater is a first-year fellow in the Hospice and Palliative Medicine Fellowship. Dr Slater graduated magna cum laude with a Bachelor of Science in Computer Science and Biochemistry from North Central College. She received her M.D. from the University of Illinois School of Medicine at Peoria. After completing her residency in Pediatrics at the Medical College of Wisconsin in Milwaukee, she completed a fellowship in Pediatric Hospital Medicine at UPMC Children’s Hospital of Pittsburgh in 2021. Her experiences in Pediatric Hospital Medicine have cultivated a passion for the inpatient care of medically complex children and seriously ill pediatric patients. Additionally, her research interests include promoting culturally sensitive care and health equity for minority populations in pediatrics. She is dedicated to teaching current and future physicians about diversity, equity, and inclusion. She enjoys baking, quilting, traveling, weightlifting, music, and spending time with her husband and their two dogs.

      Second Year Fellow

      Kelly Wolenberg Harris

      Medical School: Vanderbilt University School of Medicine
      Residency: Vanderbilt University Medical Center – Pediatrics

      Dr. Kelly Wolenberg-Harris is a first-year fellow in the Hospice and Palliative Medicine Fellowship. A native of Richmond, Virginia, Dr. Harris received a BA with Honors in both Religious Studies and Biology from the University of Chicago in 2011. She received her MD with a Certificate in Biomedical Ethics in 2016 from Vanderbilt University School of Medicine. She completed residency in Pediatrics at Vanderbilt University Medical Center in 2020, after dedicating an extra year of training as a V-StARR Resident Scholar through the NIH R38 grant to research the longitudinal experience of parents who receive a prenatal diagnosis of congenital heart disease. Her other research projects have involved qualitative, quantitative, and historical methods on topics such as clinical ethics consultation and the intersection between medicine and religion. She looks forward to a career as a physician-scientist within the fields of pediatric palliative care and medical ethics. Additionally, she enjoys reading, traveling, and experiencing new restaurants with her husband Dr. Nick Harris, who is currently a resident in Pediatrics at UPMC, and spending time with their adopted dogs, Brandy and Maxwell.

       

      Leadership

      Rebecca Sands, DO

      Program Director, Hospice and Palliative Medicine Fellowship

      Section of Palliative Care and Medical Ethics

      E-mail: sandsrl@upmc.edu

      Scott Maurer, MD

      Pediatric Site Director, Hopsice and Palliative Medicine Fellowship

      Supportive Care Program

      UPMC Children’s Hospital of Pittsburgh

      E-mail: scott.maurer@chp.edu

      Amanda Brown, MD, MS

      Pediatric Site Director, Hospice and Palliative Medicine Fellowship

      Supportive Care Program

      UPMC Children’s Hospital of Pittsburgh

      E-mail: amanda.brown@chp.edu

      Fellowship Application and Additional Information

      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:

      Rebecca Sands, DO
      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: sandsrl@upmc.edu

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

      The University of Pittsburgh Hospice and Palliative Medicine Fellowship is fully committed to anti-racism and social justice. Our mission includes the recruitment and training of a diverse community of fellows that will contribute to providing outstanding palliative care to all members of our society without bias or discrimination.

      Contact Us

      Division of General Internal Medicine Academic Offices

      UPMC Montefiore Hospital
      Suite W933
      Pittsburgh, PA 15213
      412-692-4821

      Patient/Clinical Inquiries

      412-692-4888

      Administrative Office

      412-692-4889