Hospice and Palliative Medicine Fellowship

Saint Louis University offers a one-year Accreditation Council for Graduate Medical Education (ACGME)-accredited postgraduate training program in improving the quality of life for patients and families living with chronic limiting illnesses.

Our hospice and palliative care fellowship program  produces health professionals who excel in palliative medicine and provide compassionate medical care, as well as emotional, spiritual and social support.

Program Purpose and Vision

  • To enhance care for patients and families living with serious illness with a focus on providing relief from symptoms and distress.
  • To encourage research, reflection and experiential learning for health care professionals in compassionate palliative care in alignment with the vision of SSM Health Saint Louis University Hospital and the SLUCare Physician Group.

Functions

To offer interdisciplinary team-based specialized care for patients and families with serious illnesses, including:

  • Managing complex pain and symptoms.
  • Time devoted to intensive family meetings.
  • Help with advance care planning and coordination of care in partnership with the clinical team.
  • To educate communities, hospital staff, medical students and residents about the importance of palliative care in life-limiting illness.

Educational Goals

Our curriculum employs a combination of clinical experience and didactic instruction to help you learn to support the best quality of life throughout an illness and to manage factors that contribute to the suffering of patients and their families. You will also develop skills in and experience with research, quality improvement and leadership in our rapidly growing field.

Throughout your year, you will become familiar with:

  • The different aspects of palliative and hospice medicine across all settings for patients with progressive conditions.
  • Exceptional interprofessional care for patients with advanced diseases.
  • Clinical and quality improvement research projects under the guidance of experienced mentors.

Didactics

The didactic curriculum is innovative and comprehensive, and strongly emphasizes all of the following educational domains:

  • The hospice and palliative approach to care
  • Death and dying
  • Psychosocial and spiritual support
  • Pain assessment and management in cancer and non-cancer patients
  • Assessment and management of non-pain symptoms
  • Medical comorbidity and complications with life-threatening diseases
  • Optimizing function as it pertains to quality of life
  • Communication
  • Ethical and legal decision making
  • Quality improvement and research methodology in populations with advanced illnesses

Clinical Curriculum

The 12-month clinical curriculum includes:

  • Six months of inpatient adult consultation service (three months each at two separate hospitals)
  • Two months of home hospice including pediatric home hospice
  • Two months of inpatient palliative care unit
  • Two months of electives and scholarly time
  • Longitudinal palliative care in the nursing home and continuity clinic one-half day per week throughout the year

Sample Schedule

July August September October
 
Adult and Pediatric Hospice
  • VA JC Medical Center
  • Inpatient Consult
  • VA JB Medical Center
  • Inpatient Palliative Unit
  • SSM Health Saint Louis University Hospital
  • Inpatient Consult
November December January February
Research and SSM Health Cardinal Glennon Children's Hospital Pediatric Palliative Care
  • VA JC Medical Center
  • Inpatient Consult
Adult and Pediatric Hospice
  • SSM Health Saint Louis University Hospital
  • Inpatient Consult
March April May June
  • VA JB Medical Center
  • Inpatient Palliative Unit
  • VA JC Medical Center
  • Inpatient Consult
  • SSM Health Saint Louis University Hospital
  • Inpatient Consult
Elective / Scholarly
 

Fellowship Rotations

Inpatient Palliative Care Consultation Services (Six months)

Site: SSM Health Saint Louis University Hospital, VA Saint Louis Health Care System - Jefferson Barracks Division
Faculty: Drs. Cruz, Rodin and Kornu at SSM Health Saint Louis University Hospital. Drs. Jain, Loitman and Cepeda at the VA Saint Louis Health Care System - Jefferson Barracks Division
Goal: Fellows join the inpatient palliative medicine consultation teams to assess palliative care needs, participate and eventually lead family meetings with patients, caregivers and healthcare team. Fellows see a wide variety of patients through these distinct services, which encompass a tertiary care academic medical center with Level 1 trauma center and a federally-run hospital.

Inpatient Palliative Care Unit (Two months)
Site: VA Saint Louis Health Care System - Jefferson Barracks Division
Faculty: Drs. Jain, Loitman and Cepeda 
Goal: Fellows gain direct management experience with inpatient hospice through their rotation at the inpatient palliative unit in the Saint Louis. Here you will assume the primary team role in caring for veterans nearing the end of their lives.
Long-term care (LTC) Palliative and Hospice Experience (Hospice: Two months and longitudinal) 

Site: Crossroads Hospice
Faculty: Drs. Cruz, Flaherty and Raza
Goal: Throughout the year fellows will have exposure to different settings of palliative and hospice practice, including patient homes and long-term care facilities, with the goal to gain the knowledge and skills needed to care for a patient with a terminal life-threatening illness. The rotation entails a half day per month for a hospice/palliative interdisciplinary group meeting and a four-week long rotation for two months per year of home and nursing home hospice and palliative care.

SLU- SSM Health Cardinal Glennon CMC Pediatric Palliative Care and Research Experience (One month) 
Site: SSM Health Cardinal Glennon Children's Hospital
Faculty: Drs. Shermini and Calamur
Goal: Fellows will understand the pediatric palliative care population, their families, and their multidisciplinary needs concerning medical treatment and quality of life. This rotation is a mix of research a month; the fellow will spend four days on the pediatric experience and one day doing research. 
Palliative Electives (One month) 
 Site: SSM Health Saint Louis University Hospital  and VA Saint Louis Health Care System - Jefferson Barracks Division

Faculty: Drs. Cruz, Rodin and Kornu at SSM Health Saint Louis University Hospital. Drs. Jain, Loitman and Cepeda at the VA Saint Louis Health Care System - Jefferson Barracks Division
Goal: The fellow will become familiar with the structure of palliative care in a clinically relevant field (e.g., geriatric medicine, interventional pain management, psychiatry, HIV clinic, radiation oncology, etc.) and will assist the team in pertinent procedures.

SLU-VA Ambulatory Palliative Clinic Experiences (Longitudinal) 
 Site:SSM Health Saint Louis University Hospital  and VA Saint Louis Health Care System - Jefferson Barracks Division

Faculty: Drs. Beck and Cruz at SSM Health Saint Louis University Hospital Cancer Center Supportive Care Clinic. Drs. Jain, Loitman and Cepeda at the VA Saint Louis Health Care System - Jefferson Barracks Division
Goal: Fellows will be introduced to the principles of palliative and end-of-life care for adults and elderly patients in the ambulatory setting of veterans and cancer patients.

Where We Work

Application Process

Eligibility Criteria

Qualified applicants to the geriatric  medicine fellowship program have successfully completed medical school and a residency in internal medicine, family medicine or combined internal medicine-pediatrics from an ACGME-accredited program.

Candidates must be board eligible/board certified by American Board of Internal Medicine (ABIM) and/or American Board of Family Medicine (ABFM). The division currently supports J-1 Visas and may support H-1B Visas on an individual basis.

Foreign medical graduates who have completed a non-ACGME approved internal medicine or family medicine program and are interested in a geriatric medicine fellowship should contact our division for eligibility determination.

Applications

Applications must be submitted through the Electronic Residency Application Service (ERAS). Our program participates in the National Resident Matching Program.

Interview Day

Select applicants are  interviewed by the program director and three to four faculty from the division. You will also have the opportunity to sit informally for lunch in the division, go on a tour of the campus and visit Life Care Center of St. Louis.