Hospice and Palliative Medicine Fellowship

Introducción

The Supportive & Palliative Care team at Scott & White Medical Center supports a multidisciplinary team in both the inpatient and outpatient settings. The inpatient team consists of a consult team and a primary service, which staffs 10 swing beds that function as a Palliative & Comfort Care Unit. The average number of patients seen by the SPC consult team is about 115 per month, and consults are received from a wide variety of medical specialties caring for hospitalized patients. Our team is integrated into the care of advanced heart failure patients being evaluated for surgical advanced heart failure therapies and we collaborate closely with all intensive care teams. Fellows will round with board-certified/board-eligible, fellowship trained palliative medicine faculty on both the primary service and consult service during their training and have opportunities to learn alongside residents and fellows rotating with the team. 

The outpatient program supports a co-located clinic in the Vasicek Cancer Center and an embedded clinic within the Advanced Heart Failure clinic. On average, fellows will participate in 2 clinic sessions (1 clinic session = 4 hours) each week during their 2-week ambulatory blocks, one session in the Cancer Center and one session in the heart failure clinic. Fellows will also manage a population of home-based palliative care patients in collaboration with an attending. House calls will take place ½ day per week depending on patient needs & volumes.

The multidisciplinary team supporting both the inpatient team and clinic team include: chaplain, licensed clinical social worker, child life specialist and psychologist.

Fellows will spend 4 weeks rotating at McLane Children’s Hospital for the pediatric palliative care experience. The pediatric education is supplemented by periodic perinatal palliative care consults and continuity visits with pediatric & neonatal hospice patients.

Fellows will spend 4 weeks rotating at a long-term care facility and collaborate with faculty from the Division of Geriatrics.

Fellows will have a 2 week immersion experience with Baylor Scott & White Hospice and then spend 2 days during each outpatient block with BSWH Hospice as a longitudinal experience managing hospice patients, including home visits, and attending IDT meetings under the supervision of the hospice medical director team. 

Rotations

Fellows have 27, two-week rotations that alternate between inpatient and outpatient experiences. Training requirements fulfill the ACGME standards as found in section IV.C of the Hospice and Palliative Common Program Requirements.

• Inpatient = 4 months
• Hospice = 10 weeks
• Geriatrics = 4 weeks
• Pediatrics = 4 weeks
• Outpatient = 9 weeks

Conferences and didactics

Fellows will have protected educational time on Tuesday and Thursday to attend the noon didactic lecture that will include lectures, journal clubs and board review sessions. Monthly workshops cover the following five domains: Communication Skills, Essentials of Practice, Quality Improvement/Research, Self-Care and Ethics.

Training locations

Scott & White Medical Center in Temple, Texas is the primary clinical location for the fellowship. Other locations include: Advanced Heart Failure Clinic, Vasicek Cancer Center, Baylor Scott & White Hospice.

Baylor Scott & White Health Hospice cares for about 185 patients and their families in the Central Texas area with a service area spanning 21 counties.