For medical professionals dedicated to enhancing the quality of life for patients and families facing serious illnesses, Hospice And Palliative Care Fellowship Programs offer specialized training and invaluable clinical experiences. These programs are designed to cultivate expertise in managing complex physical, emotional, and spiritual needs, ensuring comprehensive care during life-limiting conditions. A leading example of such comprehensive training is the McGaw Palliative and Hospice Medicine Program, renowned for its robust curriculum and diverse clinical rotations.
Fellows within the McGaw program embark on a year-long journey through various clinical settings, gaining exposure to a wide spectrum of patient populations and care models. This immersive experience is meticulously structured to provide a holistic understanding of palliative and hospice medicine. The core clinical rotations include significant time spent at Northwestern Memorial Hospital’s inpatient Palliative Care Service, a large academic medical center providing complex care. Fellows dedicate four months to this service, honing their skills in managing acute palliative care needs within a hospital environment.
Complementing the experience at Northwestern Memorial Hospital, fellows spend two months at the Jesse Brown Veteran’s Affairs (VA) Hospital inpatient Palliative Care Service. This rotation offers a unique perspective on serving veterans, understanding their specific health challenges and cultural nuances in end-of-life care. The VA setting provides exposure to a different healthcare system and patient demographic, broadening the fellows’ understanding of diverse needs in palliative care.
A crucial component of fellowship training is direct experience with hospice care. McGaw fellows dedicate three months to a hospice rotation, providing in-depth exposure to community-based end-of-life care. This rotation emphasizes home-based care, symptom management in the home setting, and the interdisciplinary team approach central to hospice.
To further enhance their critical care skills relevant to palliative medicine, fellows also undertake a two-week rotation in the Medical Intensive Care Unit (MICU). This experience allows them to manage acute medical complexities and understand the critical care aspects that intersect with palliative care, particularly in patients with advanced illnesses.
Recognizing the importance of specialized care across the lifespan, the McGaw program includes a two-week rotation in Pediatric Palliative Care at the Ann & Robert H. Lurie Children’s Hospital of Chicago. This dedicated pediatric experience is invaluable, providing fellows with the skills to address the unique palliative care needs of children and their families. Lurie Children’s Hospital, a premier pediatric tertiary care center, offers a rich learning environment for this specialized area.
The curriculum is further enriched with four weeks of elective time, allowing fellows to tailor their learning to specific areas of interest. Elective options are diverse and designed to deepen expertise in complementary areas. These include rotations at the Shirley Ryan AbilityLab (formerly RIC), focusing on rehabilitation and palliative care integration; the Northwestern Interventional Pain Clinic, for advanced pain management techniques; and opportunities to explore the roles of spirituality and psychiatry in palliative care. For those with a global health interest, there are also opportunities for international experiences. Additionally, fellows spend two weeks in the Palliative Care Outpatient Clinic, gaining experience in longitudinal care and the management of chronic palliative care needs in the ambulatory setting.
Pediatric Palliative Care Track: A Specialized Focus
The McGaw Palliative and Hospice Medicine Program distinguishes itself by offering a specialized “Pediatrics Track” in partnership with the renowned Pediatric Palliative Care program at Lurie Children’s Hospital. This track is ideal for fellows who are particularly passionate about pediatric palliative care. Lurie Children’s Hospital, physically connected to Northwestern Memorial Hospital, ensures seamless integration and access to resources within the larger Northwestern Medicine campus.
Fellows choosing the pediatrics track dedicate approximately eight months to pediatric palliative care experiences at Lurie Children’s, complemented by three months of adult palliative and hospice care exposure. This intensive pediatric focus provides unparalleled depth and breadth in this specialized field.
The program at Lurie Children’s Hospital offers both inpatient and outpatient consultative services, focusing on two core areas of expertise. Firstly, the program excels in pain and non-pain symptom management for children facing serious illnesses. Fellows learn advanced techniques for managing complex symptoms in the pediatric population. Secondly, the program provides crucial guidance and support for complex medical decision-making and goals of care discussions in the context of life-limiting illnesses affecting children. This includes ethical considerations, communication skills, and family-centered care approaches.
The faculty at Lurie Children’s is composed of a dedicated team of experts. This includes three full-time palliative care physicians, ensuring robust clinical mentorship and teaching. Furthermore, four additional physicians contribute to the palliative care program while also practicing in other pediatric specialties, such as hematology/oncology/stem cell transplantation, pediatric critical care, and neonatology. This multidisciplinary faculty provides diverse perspectives and specialized expertise. The team is further strengthened by five advanced practice nurses and a dedicated nurse coordinator, ensuring comprehensive and coordinated care delivery.
Beyond the core pediatric palliative care team, fellows benefit from exposure to the growing perinatal palliative care consultation service within the division. This unique opportunity allows trainees to gain experience in the sensitive and specialized area of perinatal palliative care, addressing the needs of families facing pregnancy complications and infant loss.
The multidisciplinary approach at Lurie Children’s extends to strong partnerships with other essential programs, creating a holistic support system for patients and families. These collaborations include social work and psychology services, chaplaincy, child life specialists, creative arts therapists, and Heartlight, Lurie’s bereavement program. ParentWise, another key partner, provides resources and support for parents navigating complex medical journeys.
To ensure continuity of care beyond the hospital setting, the Lurie Children’s pediatric palliative care physicians actively collaborate with community-based hospice and palliative care agencies. This includes a strong partnership with JourneyCare, a leading home hospice and palliative care agency serving the Chicago metropolitan area and beyond, as well as collaborations with other community agencies. This ensures fellows understand the transition of care and the resources available in the community.
Leading the Pediatric Palliative Care program at Lurie Children’s Hospital is Michael Certo, MD, a full-time pediatric palliative care program director. Dr. Certo’s leadership and expertise ensure a high-quality and impactful fellowship experience for those choosing the pediatrics track.
In conclusion, hospice and palliative care fellowship programs like the McGaw program, with its specialized pediatric track at Lurie Children’s Hospital, offer unparalleled opportunities for physicians seeking to specialize in this vital field. The comprehensive clinical rotations, expert faculty, and multidisciplinary approach provide fellows with the knowledge, skills, and experience necessary to become leaders in hospice and palliative medicine, improving the lives of patients and families facing serious illness.
