Palliative Medicine at Karmanos Cancer Center (4 months)

Fellows will spend 4 months at the NCI designated Comprehensive Cancer Center doing inpatient and outpatient palliative medicine.  This rotation has a strong focus on complex symptom management and effective communication.  Fellows will spend 3 weeks on the inpatient Supportive Care Service, comprised of HPM trained faculty, nurse practitioner and rotating medical students and residents.  The remaining week is dedicated to rotating in the outpatient palliative medicine clinics where our team is embedded within the oncology clinics.

The team includes a dedicated palliative care social worker, psychologist and psychiatrist.

Palliative Medicine at John Dingell VA Medical Center (3 months)

Fellows will spend 3 months at the John Dingell VAMC where fellows care for veterans with a range of life limiting conditioning including dementia, COPD, CHF, cancer and many others.  This rotation allows fellows to see the breadth of palliative care in one setting.  The rotation includes outpatient palliative care clinics, inpatient consultations and a nursing home hospice unit. 

On this unit, fellows manage the care of veterans with a wide variety of terminal illnesses who have days to months to live and require nursing home level of care.

The VA has a multidisciplinary team including HPM trained physicians, a Nurse Practitioner, Social Worker, Chaplain, Psychologist and Recreation Therapist.

Angela Hospice (1 month)

Fellows spend one month with the home care and care center teams from Angela Hospice.  Fellows get outstanding experience managing general inpatient hospice level patients in their beautiful free standing care center. 

Hospice of Michigan (2 months)

Fellows spend two months at HOM, running a fellows' team with supervision from HOM medical directors in Macomb County.  Fellows will perform home visits and attend and provide leadership for weekly Inter-Disciplinary Team (IDT) meetings.  Fellows will understand the role of all the team members of the hospice IDT by working with RNs, SW and spiritual care team members.

Pediatric Palliative Medicine (1 month)

Fellows spend one month at the Children’s Hospital of Medicine observing Dr Tremonti and her team providing high quality pediatric palliative medicine.  Fellows will also be exposed to pediatric hospice and home visits and medically complex pediatric palliative medicine clinic. Additional elective pediatric time is available if desired.

Elective/research (1 month)

• Interventional Pain
• Acupuncture
• Radiation Oncology
• Wound Care