School of Medicine

Wayne State University School of Medicine

Fellowship Training

Detroit Medical Center/Wayne State University
Fellowship Program in Hospice and Palliative Medicine

 

Program Background
 

The DMC/WSU HPM fellowship program was created and accepted its first fellow in 2005.  At that time, Hospice and Palliative Medicine had not yet been recognized by the ABMS as a specialty and there was no accreditation available for fellowship programs.  At the time, there were 40 fellowship programs around the country.  Ours was the only one in Michigan.  When ACGME accreditation became available in 2009, the DMC/WSU program gained accreditation in the first cycle and was re-accredited in 2012.

Our program provides a wide variety of experiences and provides an opportunity to care for patients in all age groups throughout the full spectrum of serious illness in ambulatory, in-patient and long-term care settings.
 

 

Training Sites

 

Detroit Receiving Hospital is an emergency, acute care hospital.  The palliative care service is staffed with an attending and two nurse practitioners with support from hospital chaplains and social workers.  There are many consults in the Intensive Care unit.  Many of these patients have multi-system organ failure.  Many patients are admitted from nursing homes.  There is abundant opportunity to have family meetings for goals setting and care planning discussions.  A variety of other patients are seen as well, with advanced heart, lung, liver and kidney disease as well as some with cancer.

 

John D. Dingell VAMC is a primary training site for the fellowship.  The current program director is stationed there and is the site director.  The VAMC has a nursing home hospice unit where fellows will manage the care of veterans with a wide variety of terminal illnesses who have days to a few months to live and require nursing home level of care.  In addition to the nursing home there is a very active Palliative Care clinic and many in-patient consults.  There is a full Palliative Care team including Physicians, a Nurse Practitioner, Social Worker, Chaplain, Psychologist and Recreation Therapist.  In addition to the NH/consult/clinic rotations, fellows also spend time in Interventional Pain clinic, Radiation Oncology and Acupunture clinic at the VA.

 

Karmanos Cancer Center is affiliated with the Detroit Medical Center on the DMC campus.  The site director is Dr. David Debono who is board certified in both Oncology and Palliative Medicine.  Fellows spend three months at KCC doing in-patient consults on cancer patients with heavy symptom burden.  Fellows also attend two weekly half day clinics.  KCC is one of 40 National Cancer Institute designated Comprehensive Cancer Centers.

 

Childrens Hospital of Michigan is on the DMC campus.  The site director is Dr. Nadia Tremonti who is board certified in Pediatrics and Hospice and Palliative Medicine and one of our fellowship graduates.  Dr. Tremonti is also a recipient of the prestigious Cunnif-Dixon Award presented through the Hastings Center for Bioethics.  The CHM rotation is either 2 or 4 weeks, based on fellow preference, background and career plans.  Additional elective pediatric time is available if desired.

 

Hospice of Michigan is a non-profit hospice and the state’s largest hospice. It has been in existence since the early 1980’s.  The site director is Dr. Evan Fonger, one of our early fellowship program graduates.  Fellows spend two months at HOM, running a fellows’ team with supervision from HOM medical directors.  Fellows will perform many home visits and attend and provide leadership for weekly Inter-Disciplinary Team (IDT) meetings.

 

Angela Hopsice is a high quality not for profit hospice.  The site director is Dr. James Boal who is board certified in Hospice and Palliative Medicine. In addition to making home visits and attending IDT meetings, fellows help care for patients living in the Angela Care Center.

 

Curriculum
 

In addition to the clinical experiences, fellows attend weekly didactic sessions where Palliative Medicine and other specialists present on pertinent topics.  In addition, at weekly conferences, fellow present complex cases for discussion and are Journal Club presenters twice a year.
 

All fellows attend the annual meeting of the American Academy of Hospice and Palliative Medicine as well as several local conferences and grand rounds.  In addition to the standard salary, an education stipend is provided to defray the cost of attendance at out of state conferences.
 

Fellows have ample opportunity to teach other learners, both residents and medical students who rotate on Palliative Medicine at several of the sites.
 

All of the sites are fully staffed with physician and non-physician providers, so education, conference attendance, etc. is never hindered by service responsibilities.
 

All fellows participate in a quality improvement and/or research project during their training.
 

Fellows will participate in Hospital Ethics Committee and other committee meetings.
 

Our board passage rate is 100%

 

Contact:
Mike Stellini, M.D., M.S.,FACP, FAAHPM
mstellini@med.wayne.edu
313-319-3340