Montefiore Medical Center/Albert Einstein College of Med at MJHS Hospice and Palliative Care Program

The Fellowship in Hospice and Palliative Medicine at Montefiore Medical Center/Albert Einstein College of Medicine at MJHS is an ACGME-accredited program designed to provide an extensive training experience in hospice and palliative care. The program is dedicated to the education of future palliative care specialists and provides diverse clinical experiences across various practice settings. The fellowship accepts three physicians annually and is structured to meet the growing demand for competent professionals in this important subspecialty.

The core of the training involves rotations that are divided into 4-week blocks, allowing fellows to immerse themselves in different facets of care. These rotations include inpatient consultation services, community-based hospice, and long-term care facilities. Participation in interdisciplinary teams is a hallmark of the fellowship, fostering collaboration among various healthcare professionals including those in nursing, social work, psychology, and research 1.

Clinical Curriculum

The clinical curriculum comprehensively prepares fellows through various rotations:

• Inpatient Consultation Team (4 Blocks): Fellows work on the inpatient consultation service at Montefiore Medical Center, one of the largest teaching hospitals in the nation. They gain experience in managing complex medical and psychosocial problems in a diverse patient population.
• Dedicated Inpatient Unit (1 Block): In a specialized 10-bed unit, fellows manage patient care through effective teamwork and communication, enhancing their palliative decision-making skills.
• Home Hospice (4 Blocks): This rotation involves performing home visits and participating in an interdisciplinary case management approach tailored to home-bound patients.
• Facility-Based Palliative Care (2 Blocks): Fellows engage in consulting services at The New Jewish Home and Isabella Center, focusing on care in skilled and long-term care settings.
• Long-Term Care (1 Block): Experience in a rehabilitation center builds competency in geriatric syndromes and comprehensive interdisciplinary care plans.
• Elective (1 Block): Options include specialized areas such as hospice administration and palliative research.
• Ambulatory Care (6 or more months): Fellows participate in outpatient clinics focusing on symptom management and advanced care planning.

Fellows are expected to evaluate a minimum of 300 new patients, conduct home visits, and follow patients longitudinally across settings 1.

Educational Curriculum

The fellowship features a robust educational curriculum characterized by:

• Weekly Didactic Lectures: Covering crucial topics such as palliative care models, symptom management, and advance care planning.
• Interprofessional Didactic Sessions: These sessions cater to the continued education of practitioners from different disciplines, fostering a well-rounded understanding of palliative care.
• Communication Skills Training: Integral to palliative care, training focuses on serious illness discussions and effective family meeting techniques.
• Scholarly Activities: Fellows are required to participate in quality improvement studies and have opportunities to engage in research activities with faculty, enhancing their academic and clinical prowess.

The educational component is designed to prepare fellows to not only provide compassionate care but also to lead initiatives that improve palliative care delivery 1.

Application and Competitiveness

The application process is conducted through ERAS and requires a complete application package including a curriculum vitae, personal statement, three letters of support, and USMLE scores. This program is highly competitive; candidates with prior experience in internal medicine, family medicine, or pediatrics are particularly encouraged to apply. Consideration is given to DO candidates and international medical graduates (IMGs), making it more accessible for a diverse pool of applicants. However, applicants should have graduated from medical school within a certain number of years to be eligible and should ideally not have failed more than one USMLE Step examination attempt 1.

Visa Support

The program offers visa support for international applicants. It typically sponsors J-1 visas for foreign medical graduates in compliance with prevailing regulations and requirements. This allows IMGs to pursue training in the program, promoting a diverse educational environment 1.

Unique Aspects of the Program

The fellowship at MJHS not only focuses on clinical training but is also integrated with robust research activities aimed at improving palliative care practices. The MJHS Institute for Innovation in Palliative Care conducts various studies aimed at addressing health disparities, enhancing care delivery models, and optimizing patient outcomes in palliative care settings. This commitment to research and education underlines the program's overarching goal to enhance access to palliative services for patients experiencing serious illness. Additionally, the institute organizes interprofessional educational programs to broaden the skills of healthcare providers across multiple disciplines 1.

This comprehensive fellowship provides the knowledge, skills, and competencies required for a fulfilling career in hospice and palliative care, generating palliative leaders who are well-equipped to address the complex needs of patients and families coping with serious illness.