Dartmouth-Hitchcock/Mary Hitchcock Memorial Hospital Program

The Hospice and Palliative Medicine Interprofessional Fellowship at Dartmouth Hitchcock Medical Center is designed to train fellows in a multidisciplinary setting to deliver high-quality care to patients with serious and life-limiting illnesses. The program is located in Lebanon, NH, within a 460-bed tertiary care referral center, serving a diverse patient population that predominantly includes individuals facing significant healthcare access challenges.

The fellowship is ACGME-accredited and offers unique training opportunities, including rotations across various specialties such as hematology-oncology, cardiology, and neurology, allowing fellows to gain comprehensive experience in both inpatient and outpatient settings. Fellows work closely with an interdisciplinary team that includes physicians, nurse practitioners, clinical pharmacists, social workers, and chaplains, contributing to a holistic approach to patient care 1.

Curriculum Details

The curriculum integrates clinical rotations, a longitudinal outpatient experience, and a structured educational experience.3 Through a flipped classroom model, fellows participate in interactive didactic sessions that enhance learning opportunities. A significant component of the fellowship is focused on communication skills, employing frameworks such as the Serious Illness Conversation Guide from Ariadne Labs, which aims to improve conversations with patients about their respective care preferences and experiences during serious illness.

Fellows are trained in advanced symptom management, particularly for those with comorbidities such as substance use disorders, by engaging in specialized outpatient clinics and case-based learning. Additionally, there is a strong emphasis on Narrative Medicine to foster self-awareness and emotional understanding, providing fellows with essential skills for effective communication in hospice and palliative care 3.

Rotations and Experience

The program enables fellows to engage in diverse clinical experiences across various affiliated sites, including local home hospice programs and long-term care facilities. Clinical rotations also extend to the Jack Byrne Center for Palliative and Hospice Care, where fellows participate in managing complex cases alongside experienced practitioners 1. The inclusion of pediatric palliative care experiences, social work exposure, and collaboration with the Veterans Affairs Medical Center further enriches the fellowship experience.

Research and Faculty

The faculty supporting the fellowship includes national leaders in communication education and end-of-life care research. This collaborative environment fosters an ambiance where fellows can contribute to ongoing research initiatives while developing their clinical expertise 4. The core faculty consists of board-certified professionals in Hospice and Palliative Medicine, enhancing the educational experience through mentorship and involvement in didactic teaching.

Fellowship Opportunities and Advancement

The fellowship offers the option of a combined Leadership Preventive Medicine Residency (LPMR) track, providing fellows with opportunities to pursue advanced degrees such as an MPH or MS while completing their clinical training. The program aims to produce well-rounded clinicians capable of leading practices in palliative care settings and influencing health policy 1.

Demographics and Outcomes

Fellow demographics demonstrate a rich diversity of backgrounds, including training from internal medicine, family medicine, and anesthesiology. Upon completion, over half of the graduates typically transition into academic roles or regional healthcare positions, contributing to the mission of improving palliative care delivery 5.

Application Process

The application process is competitive, with the program offering three fellowship positions each year. Applicants must hold a valid ECFMG certificate and have board eligibility in one of the respective sponsoring specialties. Essential application materials include medical school letters, transcripts, USMLE scores, a personal statement, and letters of recommendation with an emphasis on interprofessional collaboration 6. The program welcomes both DO and IMG applicants, maintaining a commitment to diversity across its cohorts.

Visa Support

The program supports visa sponsorship for qualified international medical graduates. Typically, it provides support for J-1 and H-1B visas, facilitating opportunities for fellows from around the world to participate in the training.

Diversity and Inclusion

Dartmouth Hitchcock Medical Center promotes diversity, equity, inclusion, and belonging as part of its educational mission, striving to create an inclusive learning environment for all fellows 1.