Office of Medical Education

Pediatric Hospice and Palliative Medicine Fellowship

The ACGME accredited Pediatric Hospice and Palliative Medicine Fellowship is a one year program with a 12 block rotation academic calendar. Our interdisciplinary palliative care team averages approximately 300 patient consults per year.

Fellows will train in all inpatient units across Johns Hopkins All Children’s Hospital. Units include NICU, PICU, CVICU medical/surgical units, and cancer center. During these rotations, fellows work as members of the interdisciplinary consultation teams, receiving clinical training in the full range of palliative care assessment, multidimensional care planning including appropriate acute and non-acute symptom management, counseling patients and families, supporting ethical health care decision-making, and working with referring physicians and teams to implement palliative care recommendations in the inpatient setting. This experience will provide fellows with skills and knowledge necessary to work effectively with interdisciplinary team members, other physicians including surgeons, intensivists, hospitalists and other medical subspecialists, as well as patients and their families to prevent and relieve suffering. Fellows care for patients from a diverse range of multicultural and socioeconomic populations with a broad spectrum of diagnostic and palliative care needs, including cancer and non-cancer conditions, cognitive impairment, ventilator dependence, g-tube dependence, cystic fibrosis and epilepsy among other conditions with mixed payer resources. The hospital has diagnostic laboratory, imaging services, and a range of consulting physicians.

The fellow will have the opportunity to participate in research, quality improvement and education through scholarly activity. Didactic lectures will occur twice monthly during training. Training will include home visits at Empath Health, a local hospice provider, as well as a rotation with an inpatient Pediatric Rehabilitation Program.

This program provides fellows the opportunity to learn the full administrative and medical aspects of hospice care including referral acceptance, admissions process, patient certification, and various levels of inpatient care and use of the Medicare Hospice benefits.

Hospice and Palliative Medicine focuses upon patients with life-threatening and terminal illness resulting from all diagnoses. Learners are expected to understand end stage processes for common disease states including normal life closure as well as palliative aspects of chronic illness, actual management of patient and family issues near time of death, and the bereavement period. Much of the important teaching that takes place in Hospice and Palliative Medicine is interdisciplinary and occurs during daily teaching rounds (both inpatient and consultative); regular conferences in palliative care, oncology, neurology, organ-specific disciplines, ethics, and pain management; the palliative care journal club and other educational events available at all training sites. Fellows will be expected to participate in these sessions. Supervising physicians and non­physician faculty routinely participate in these teaching venues. Each rotation has an associated interdisciplinary team that seeks physician input as one primary aspect of care delivery. The team experience itself is a significant part of the education.

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