Mercy Hospital (St Louis) Program

The Hospice and Palliative Medicine Fellowship Program at Mercy Hospital in St. Louis is designed to cultivate physicians who prioritize compassionate care alongside superior clinical service. The program trains two fellows annually for a one-year duration, focusing on a multidisciplinary approach to managing pain and alleviating distressing symptoms tied to serious illnesses. This has the overarching goal of enhancing the quality of life for patients and their families 1.

The curriculum is structured to offer a comprehensive clinical experience, incorporating various rotations that include inpatient consult services, outpatient palliative care clinics, long-term care facilities, pediatric palliative care, and hospice care, either at home or in a facility. Elective rotations add diversity to the training, allowing fellows to explore areas like oncology, pulmonary critical care, ethics, radiation oncology, cardiology, neurology, and geriatrics 2.

Clinical Rotations

The fellowship features a detailed schedule of clinical rotations:

• Inpatient Palliative Care Consultation Service: 5 months, engaging with interdisciplinary teams in various high-acuity settings including ICUs and the emergency department of a Level 1 trauma center.
• Outpatient Palliative Care: 6 months, fellows see patients longitudinally in general outpatient clinics and specialized outpatient settings.
• Home Hospice: 2.5 months, focusing on home visitations to manage symptom control and recertification of hospice benefits.
• Long-term Care: 1 month, delivering palliative care consultations in skilled nursing facilities.
• Pediatric Palliative Care: 1 month, collaborating within pediatric teams in NICUs and hematology centers.

Additionally, fellows dedicate 2.5 months to elective rotations tailored to their professional interests, while also undertaking a quality improvement or research project 2.

Research and Learning Opportunities

Fellows in the program are presented with diverse opportunities to strengthen their clinical teaching abilities and involve themselves in research activities. Participation in case presentations, structured reflections, and a palliative care journal club is a notable aspect 1. The program encourages fellows to engage in scholarly research with support from an Institutional Review Board (IRB), aiming for presentations at the annual Mercy Research Colloquium.

Training Environment

Mercy Hospital, the second-largest hospital in St. Louis with 979 licensed beds, provides a rich training environment that serves a varied patient demographic. The Palliative Care service at Mercy, operational since March 2004, forms a critical component of the fellowship's educational framework. The program is also recognized with Joint Commission Certification since 2013, establishing its standard of excellence 1.

Fellowship Competitiveness

The fellowship is perceived as highly competitive, attracting candidates from diverse backgrounds, including osteopathic and international medical graduates (IMGs). Prospective fellows should have completed their residency and express a committed interest to the components of hospice and palliative medicine 2.

Special Application Requirements

Applications are typically processed through ERAS, with specific requirements that may include having completed residency within a certain time frame, and there might be limits on the number of failed STEP examinations. While each application is evaluated on a variety of components, the program is open to diverse educational backgrounds and training experiences, fostering an inclusive environment for prospective fellows 2.

Visa Sponsorship

The program supports various visa types for international candidates, facilitating their application for training in the United States. This support ensures that qualified foreign medical graduates have the opportunity to apply and train in an immersive fellowship program 1.