About Us
The HCA Florida Healthcare JFK Hospital/University of Miami Miller School of Medicine GME Consortium Hospice and Palliative Medicine Program prepares selected physicians for board certification in hospice and palliative medicine. The consortium is comprised of four top-notch entities that include HCA/JFK Hospital, University of Miami, Trustbridge Hospice and West Palm Beach Veterans Affairs Medical Center. These institutions maintain a high level of excellence and are committed to providing high quality, educated physicians to serve the community.
Core values that the Hospice and Palliative Medicine Program embrace and embody are:
- Integrity
- Professionalism
- Compassion
- Accountability
- Cultural Safety
- Respect & Team Work
- Innovation
- Highest Quality of Care
- Groundbreaking Transformative Patient Care
- Continuous Improvement
The Hospice and Palliative Medicine Program not only values high quality, educated physicians but also at the core of the program is who we are as individuals. The program is not only dedicated to providing a strong education base related to Hospice and Palliative Medicine for the next generation of physicians but also strives to continue to provide compassionate, warm, strong community leaders and human beings. As HCA Florida Healthcare JFK Hospital (2024) states, “Above all else, we are committed to the care and improvement of human life.”
Hospice and Palliative Care is a unique specialty; it can be very complex and multidimensional. Hospice and Palliative Medicine requires a holistic approach, which is incorporated into each aspect of the program.
Program Objectives
The program embraces the following ACGME-specified objectives for the selected fellow:
Patient Care and Procedural Skills: Demonstrate compassionate, appropriate, effective care for treating health problems and promoting well-being in a palliative care setting.
Medical Knowledge: Relate empirical medical knowledge and apply it to patient care.
Practice-based Learning and Improvement: Analyze practice experience and perform practice-based improvement activities using systematic knowledge.
Interpersonal and Communication Skills: Create and sustain a therapeutic and ethically sound relationship with patients, families and other healthcare professionals.
Professionalism: Demonstrate professionalism that supersedes self-interest through care, compassion, integrity and responsiveness to the needs of patients and society.
Systems-based Practice: Practice cost-effective healthcare and resource allocation that does not compromise the quality of care; advocate for quality patient care and assist patients in dealing with system complexities.
Sample Schedule:
Program Overview
The fellowship admissions committee selects up to two fellows each year for participation in the program. The program gained ACGME accreditation under the HCA Florida JFK Hospital Internal Medicine Program in May of 2010.
The hospice and palliative medicine fellow will gain clinical expertise through a variety of patient care experiences in a range of settings. The program consists of 13 blocks and contains 20 different rotations along with sub ancillary rotations that include wellness and self-study days. The program also diligently prepares fellows for their boards by having preparatory exams along with reviews. Our program pass rate is extremely high.
Orientation
The fellow will undergo an extensive orientation program conducted by the HCA Florida JFK Hospital, West Palm Beach VA Center, and Trustbridge. This orientation will be approximately three weeks and will include but are not limited to Human Resource policies and procedures, benefits, EMR training, didactics sessions, clinical training, team building exercises, etc.
IPU Core
The fellow begins their course of study in a Trustbridge dedicated hospice inpatient care center located at Baptist Bethesda East Hospital or Gerstenberg. This rotation will start either in block two or three following the administrative or home core block. The objective of this rotation is to provide the fellow core concepts in both medical and psychosocial aspects of hospice and palliative care.
The fellow will pre-round on patients admitted to the IPU. Teaching rounds follow working rounds with faculty. The rotation will also consist of lectures, didactic sessions, article reviews, new patient consults and other clinically relevant activities.
Home Core
The home core assignment will be a four-week rotation. After the intense four-week rotation, the fellow will continue to follow a small cohort (10-30) of patients for the remainder of the academic year. The focus of this experience is to allow the fellow to follow patients with a prognosis of six months or less throughout the trajectory of their terminal illness.
The home team carries an average daily census of 80-120 patients. This patient population provides a strong mix of ethnicities and cultures, as well as the opportunity to provide generational care. This experience will allow the fellow to participate in care planning from the time of terminal diagnosis through difficult decision-making options, which allows for critical interactions with patient/family and other support systems. The fellow will attend weekly interdisciplinary team meetings and complete home visits with various members of the team. This rotation will include opportunities to develop the skills needed to function in an outpatient setting and experience the unique challenges of caring for patients in homes, skilled nursing facilities and assisted living facilities.
IPU Longitudinal/VA IPU
The IPU Longitudinal and VA IPU experience provides day-to-day management of hospice patients who are admitted for symptom management, family education as well as acting as a resource for consultative services when necessary. This is a three-month experience and takes place at Gerstenberg (2 months) and VA (1 month).
The fellow reports to the unit at 7:00 a.m. for pre-rounds. Teaching rounds are completed with the interdisciplinary team. Upon completion of rounds, the fellow will dictate progress notes. With assistance of the social worker and attending physician, the fellow will arrange for family conferences as needed. Furthermore, if there are residents or medical students, the fellow will supervise, mentor and teach as needed.
JFK Palliative
JFK Palliative Rotation will provide the fellow the required inpatient palliative care consultation experience per the ACGME. The fellow will complete a dedicated two-block rotation at JFK Medical Center. The fellow will round in the morning with the palliative care team in the ICU. In addition, the fellow will teach and direct residents and medical students in the palliative care setting. Furthermore, the fellow will assist the admission department as it relates to removal of life staining therapies as indicated.
This rotation will also include Schwartz rounds as a longitudinal experience throughout the fellowship. The fellow should anticipate leading at least three Schwartz rounds throughout the academic year.
VA Pain Management and Rehab
The Pain Management and Rehab rotation will be at the West Palm Beach Veterans Affairs Medical Center. This rotation is a one-month session. The fellow will participate in the delivery of high-quality medical diagnosis and invasive pain management techniques in an outpatient and inpatient setting.
VA LTC
The Community Living Center (CLC) at the West Palm Beach Veterans Administration Medical Center will be the designated site for the LTC experience. The CLC provides an excellent site for meaningful longitudinal care of patients. The CLC contains a 60-bed LTC facility, as well as a 10-bed palliative care and 10-bed hospice unit. The fellow will assume responsibility for evaluation of the LTC residents' daily medical needs, as well as following patients as they transition to the palliative and hospice units. This experience will allow the fellow to gain valuable insight into the needs of the geriatric population.
Medical Examiner
The Medical Examiner Rotation is a five (5) day rotation and will be at the Palm Beach County Medical Examiner’s Office. The fellow will participate in daily conferences, autopsies (optional), and microscopic pathology essential to the investigation and certification of death. The fellow will spend time with the Medical Investigators to learn the jurisdiction of the Medical Examiner’s office. This rotation will assist fellows in completing death attestations appropriately.
Palliative Cardiology
This one-week Palliative Cardiology Rotation will be at HCA/JFK Medical Center under the supervision of the Cardiology Department. The fellow will participate in the delivery of high-quality palliative cardiology care with the emphasis on palliative care for congestive heart failure. There will also be training related to LVAD support, maintenance and removal.
Radiation Oncology
The Radiation Oncology experience will be a 2-week rotation. The fellow will be assigned to GenesisCare at Good Samaritan Hospital. The fellow will participate in the delivery of high-quality medical diagnosis and interventions to cancer/palliative care patients. Topics covered during this rotation include but are not limited to palliative treatment for brain metastases, radiotherapy in bone metastases, multidisciplinary approach to breast cancer, systemic and local radiation therapy side effects, and indications for cyber knife treatment related to brain metastases.
Pediatrics
Trustbridge provides care to patients of all ages. A 2-week rotation with the Pediatric Oncology Support Team will be required. Additionally, time is spent in an outpatient setting as well as the hospital. This experience will provide an opportunity for the fellow to follow children who are chronically ill as well as terminally ill. The Pediatric Oncology Support Team has a comprehensive psychosocial program utilizing a specialized team to provide longitudinal care to patients and their families. The fellow will work with the interdisciplinary team to evaluate and establish a plan of care for these children and their families.
Palliative Surgery-Bereavement/Self Care
The Palliative Surgery experience is a 2-week rotation that coincidences with the Bereavement/Self Care rotation. Palliative surgery rotation is held in the mornings and the Bereavement/Self Care rotation is held in the afternoon. Both rotations are at Trustbridge. The palliative surgery block will also include extensive training related to palliative and hospice wound care.
The Bereavement/Self Care experience will provide the fellow a comprehensive opportunity to work with the Bereavement Center. The fellow will meet with bereavement counselors to observe counseling services amongst family members including children.
Furthermore, the fellow will spend time with the integrative therapy department. The objective for the integrative therapy department is to concentrate on self-care and utilization of alternative therapies to relieve stress. Consequently, this will allow the fellow to gain a deeper understanding of the values of these therapies and how they play an essential part in patient care.
Elective
The fellow will select a one-month elective, which will be subject to the approval of the Program Director.
Opportunities available, but not limited to:
- Ethics consultations
- Geriatric medicine
- Interventional pain management
- Medical psychiatry
- Pediatrics
- HIV clinic
- Medical oncology
- Radiation oncology
- Pulmonary
- Cardiology
- Neurology clinics
In addition to clinical training, the fellow will be required to attend scheduled didactic lectures, monthly journal club, committee meetings and Schwartz rounds. The fellow will assist with teaching opportunities as their knowledge base increases.
Although research is not a required component of the program, the fellow will be expected to complete a scholarly project or presentation prior to the end of the fellowship. The fellow will be encouraged to attend the live annual conference for the American Academy of Hospice and Palliative Medicine.
