The Hospice and Palliative Medicine Fellowship at Memorial Sloan Kettering Cancer Center (MSKCC) stands as a leading program within the Supportive Care Service, Department of Medicine. Accredited by the Accreditation Council for Graduate Medical Education (ACGME), this esteemed fellowship annually welcomes six physician fellows. It fosters a unique learning environment where medical doctors train alongside Advanced Practice Provider Fellows in Hospice and Palliative Care, promoting interprofessional collaboration. Eligible candidates are doctors who have completed ACGME-accredited residency in a wide range of specialties, including internal medicine, family medicine, and surgery, amongst others. This program is meticulously designed for those dedicated to becoming experts and future leaders in hospice and palliative medicine, with a strong emphasis on effective communication strategies in sensitive care settings.
Mission: Shaping Compassionate and Skilled Palliative Care Leaders
The core mission of the Hospice and Palliative Medicine Fellowship at MSKCC is to develop doctors into highly qualified, compassionate, collaborative, committed, and scientifically inquisitive specialists and academic leaders within palliative care. A crucial component of this mission is to hone their abilities in patient-centered communication, ensuring they can navigate the complexities of palliative care with empathy and expertise.
A Legacy of Excellence in Palliative Care Communication
MSKCC’s pioneering role in palliative care practice and training dates back to the 1980s. Visionaries like Dr. Kathleen Foley, a neurologist, and nurse practitioner Nessa Coyle were pivotal in establishing the foundations of this field. Their early work was instrumental in educating the first generation of pain and palliative care specialists, including nurses, social workers, and chaplains, emphasizing the importance of interdisciplinary communication. Today, MSKCC’s Supportive Care Service builds upon this rich legacy, boasting over four decades of leadership in complex pain management, psychosocial palliative care, and, significantly, communication skills training. With a rapidly expanding interprofessional team exceeding 70 members, MSKCC seamlessly integrates its training program, clinical service, and research initiatives across both inpatient and outpatient environments. This long-standing history guarantees an exceptionally strong foundation for the training experience offered by the Hospice and Palliative Medicine Fellowship, particularly in the area of palliative care communications program development and implementation.
Comprehensive Training Program: Mastering Palliative Care and Communication
The fellowship’s comprehensive training program is designed to equip fellows with the essential knowledge and skills to excel as palliative care providers. A key focus is placed on mastering communication techniques to effectively treat a diverse range of patients and families across various care settings.
Clinical Rotations: Real-World Communication Challenges
The cornerstone of the clinical experience is the Inpatient Consult Service. Here, fellows collaborate closely with an interdisciplinary team comprising physicians, advanced practice providers, social workers, chaplains, and a specialized palliative-care-trained pharmacist. This team-based approach exposes fellows to the high acuity and complexity inherent in palliative care, demanding proficiency in both symptom management and nuanced communication.
To ensure a well-rounded perspective, rotations extend beyond the inpatient setting. Fellows gain experience in the ambulatory practice utilizing telemedicine, pediatric palliative care, and hospice care through partnerships with organizations such as the Visiting Nurse Service of New York and Calvary Hospital. Furthermore, a four-week rotation at the Palliative Care Service at NewYork-Presbyterian/Weill Cornell Medical Center broadens their experience to include providing care for patients with a wider spectrum of illnesses beyond cancer. These diverse clinical settings are crucial for developing versatile communication skills applicable to various patient populations and care models.
Curriculum: Dedicated Learning for Enhanced Communication Proficiency
The fellowship features a thoughtfully designed curriculum delivered during weekly Academic Mornings. This dedicated time, protected from clinical duties, allows fellows to concentrate on professional development, including specialized training in communication strategies. Lunch is provided during these sessions, fostering a collaborative learning environment. Academic Mornings typically culminate in the Supportive Care Grand Rounds, providing fellows with invaluable exposure to intricate clinical cases and varied perspectives, often highlighting communication challenges and successful interventions.
Interactive and Didactic Sessions: Honing Communication Expertise
- Symptom Management and Pharmacology: Fellows delve into evidence-based pharmacological and non-pharmacological strategies for managing a broad spectrum of symptoms commonly encountered in palliative care. While addressing physical symptoms is paramount, the curriculum underscores the importance of communicating treatment plans and symptom experiences effectively to patients and families.
- Communication Skills: Fellows actively participate in the renowned ComSkil program, a cornerstone of the fellowship’s commitment to developing exceptional communicators. This program is specifically designed to equip fellows with the skills to navigate sensitive and challenging conversations with patients, families, and interdisciplinary colleagues. It addresses topics such as breaking bad news, goals of care conversations, conflict resolution, and cultural sensitivity in communication.
- Care Coordination and Medical Ethics: Sessions explore best practices in care coordination across diverse healthcare settings and delve into the complex ethical dilemmas frequently encountered in palliative care. Effective communication is highlighted as essential for ethical decision-making, particularly in end-of-life care and shared decision-making processes.
- Psychosocial Support: Fellows gain a deeper understanding of the psychosocial dimensions of palliative care, learning to provide holistic support for patients and their families facing serious illnesses. Training emphasizes therapeutic communication techniques to address emotional distress, grief, and existential concerns.
Additional Learning Opportunities: Expanding Communication Skillsets
- Interactive Case-Based Learning Series: Fellows actively participate in case discussions to refine their clinical reasoning and decision-making abilities, with a focus on communication strategies in complex patient scenarios.
- Resiliency and Well-Being: Recognizing the emotional demands of palliative care, fellows engage in group supervision with a dedicated social worker and attend workshops focused on cultivating resilience and well-being. These sessions often address communication strategies for self-care and managing burnout.
- Narrative Medicine Series: This series explores the power of narrative medicine in understanding the patient’s experience and fostering empathy in clinical practice. Fellows learn how to utilize patient stories to enhance communication and build stronger patient-physician relationships.
- Existential Rounds: A weekly forum provides a safe space for fellows to share challenges, celebrate successes, and connect through open discussions and reflective exercises, often using themed poems and readings to stimulate conversations about meaning and purpose in palliative care communication.
This comprehensive curriculum provides a robust foundation for fellows to become not only exceptional palliative care providers but also highly skilled and compassionate communicators, adept at navigating the sensitive interpersonal dynamics inherent in this field.
Scholarly Opportunities: Advancing Palliative Care Communication Knowledge
Required Activities: Fellows are required to complete a diverse portfolio of scholarly activities, including submitting an abstract to the American Academy of Hospice and Palliative Medicine (AAHPM), delivering case presentations, participating in journal club discussions, engaging in ethics forum debates, developing a supportive care panel, and culminating in a Supportive Care Grand Rounds presentation. Many of these activities provide opportunities to focus on communication-related research or case studies.
Additional Opportunities: Fellows can further enrich their scholarly experience by collaborating on quality improvement projects, engaging in ongoing research, gaining teaching experience, or applying for the Frances Young Tang Research Fellowship. There are opportunities to focus research projects on improving palliative care communication models or assessing the effectiveness of communication training programs.
Application Deadline and Program Details
The application cycle commences one year prior to the fellowship start date. Applications are accepted starting in July through the Electronic Residency Application Service (ERAS), with interviews conducted through October.
Length of Program: One year, with the option to apply for a second year as the Frances Young Tang Research Fellow.
Eligibility: Applicants must have completed an ACGME-accredited residency program in various specialties including family medicine, internal medicine, and neurology, prior to commencing the fellowship.
Number of Positions: Six
How to Apply: Join MSKCC’s Palliative Care Communication Focused Fellowship
Applications to the Hospice and Palliative Medicine Fellowship are submitted via the ERAS application system during the July cycle. The National Resident Matching Program is utilized to fill all positions. Interviews are held from late August through October. All applications are reviewed and ranked by November in preparation for the December match. Required application materials include three letters of recommendation (one from the residency or current program director), a personal statement, and test scores (USMLE or ECFMG).
Frances Young Tang Research Fellowship: Deep Dive into Palliative Care Research
The Frances Young Tang Research Fellowship offers a unique one-year mentored research experience for physicians who have completed their hospice and palliative medicine fellowship training. This program is ideal for physicians passionate about research and dedicated to advancing knowledge in palliative care, including the critical area of palliative care communications program development.
Research fellows gain protected time to:
- Conduct research under the guidance of experienced mentors, potentially focusing on communication-related projects.
- Develop expertise in designing and executing palliative care research studies, including communication-based interventions.
- Cultivate skills necessary for publishing research findings in peer-reviewed journals, contributing to the evidence base for effective palliative care communication.
- Strengthen their research foundation through enrollment in a research methodology course offered by Weill Cornell Medical College.
Application Process for the Frances Young Tang Research Fellowship
The Frances Young Tang Research Fellowship has a separate application process with a deadline of January 2. Required materials include:
- A statement of purpose outlining research interests and career goals, potentially focusing on communication research.
- A writing sample of prior research work (e.g., publication, abstract).
- A letter of recommendation from a mentor familiar with the applicant’s research interest and experience.
- Curriculum Vitae (CV).
Interested applicants are encouraged to inquire about the research fellowship and application process by contacting [email protected].
Acknowledgement
The Barbara Ziegler Palliative Care Educational Program and the Tang Family Foundation are acknowledged for their generous support of the Hospice and Palliative Medicine Fellowship and the Frances Young Tang Research Fellowship, respectively, furthering the advancement of palliative care education and research, including vital communication skills training.
Previous Fellows
Ameish Govindarajan, MD
MIchael Lau, MD
Tristan Lee, MD
Carley Mitchell, MD
Amna Rana, MD
Lauren Ward, MD
Ameish Govindarajan, MD
UCLA Kern Medical Internal Medicine Residency
Medical School: Ross University School of Medicine
Future Plans: Dr. Govindarajan has received the Frances Young Tang Research Fellowship in Palliative Medicine at Memorial Sloan Kettering Cancer Center and plans to pursue a Hematology Oncology fellowship.
Michael Lau, MD
Medical School Name: University of Central Florida, College of Medicine
Residency Program Name: Kaiser Permanente Los Angeles Medical Center, Residency, Pediatrics
Other Fellowships: FTHS Fellowship, GME, Pediatrics – Pediatric Hematology/Oncology
Future Plans: Michael Lau will be joining Kaiser Permanente Southern California (Fontana) in September 2024
Tristan Lee, MD
Medical School Name: Duke University School of Medicine
Residency Program Name: New York Presbyterian Hospital, Resident in Internal Medicine
Carley Mitchell, MD
Carley Mitchell completed medical school at Drexel University College of Medicine in 2020 and went on to complete an internal medicine residency at Case Western Reserve University Hospitals. After completing her HPM fellowship, she will be pursuing a hematology/oncology fellowship at University Hospitals – Seidman Cancer Center.
Amna Rana, MD
Medical School Name: Eastern Virginia Medical School – Norfolk, VA
Residency Program Name: Medstar Georgetown University Hospital; Internal Medicine Residency
Amna Rana has accepted an offer from Columbia to join as faculty for full-time palliative care physician. She will be joining in February 2025.
Lauren Ward, MD
Medical School Name: University of Minnesota Medical School
Residency Program Name: UT Southwestern Medical Center; Internal Medicine Residency
Lauren Ward has accepted an offer as a Critical Care Medicine Fellow with University of Pittsburgh Medical Center.
