During your 12-month Hospice and Palliative Medicine Fellowship, you:

  • Learn prognostic criteria for patients with life-limiting illnesses
  • Learn functional assessments to assist in coordinating care
  • Discuss empathically palliative treatment options with patients, families and professionals
  • Perform visitation and home care as an important component of end-of-life care
  • Make appropriate referrals to other professionals for diagnostics and therapeutics necessary to meet the needs of patients
  • Work with the Ethics Committee as necessary
  • Translate the needs of the patient into an appropriate action plan with empathy, efficiency and expediency
  • Demonstrate excellence in communication between the patient, family and palliative care team
  • Perform pain assessment and incorporate the World Health Organization analgesia ladder
  • Learn to use opiates, narcotic equivalences and conversions as needed
  • Learn anesthesia procedures
  • Lead palliative care team meetings
  • Coordinate and lead family meetings
  • Research and publish articles regarding palliative medicine
  • Coordinate and perform bereavement evaluation and follow-up
  • Demonstrate cost-effective symptom evaluation and management
  • Learn how to balance professional and personal opportunities and obligations in harmony and balance (for example, how to avoid burnout and maladaptive coping mechanisms)
  • Lecture and teach medical students, nurses and other members of the health care team about the special aspects of palliative medical care — that is, "spread the word" by being an advocate of palliative medicine in the community to promote the benefits of and increase access to Medicare hospice benefits
  • Learn and apply the Medicare and Medicaid qualifications, requirements, and eligibility rules and regulations, as well as managed care and HMO mandates
  • Demonstrate a working proficiency of ethical principles, including autonomy, beneficence, non-maleficence, justice, informed consent, euthanasia, decision-making capacity, substituted judgment, utility, futility and benefit-risk analysis
  • Learn empathic interviewing techniques
  • Take a spiritual history and be sensitive to cultural variations
  • Incorporate the patient's cultural, spiritual and experiential perspectives to design an individualized care plan

You learn clinical palliative care and hospice care with a team of professionals from Mayo Clinic, Community Hospice of Northeast Florida inpatient unit (Earl B. Hadlow Center for Caring), nursing homes and private homes. You also serve as a consultant for inpatient evaluations on the Palliative Care Consultative Service at Mayo Clinic, including Mayo Clinic Hospital.

Longitudinal care of individuals enrolled in Community Hospice enables you to evaluate and participate in care over the 12-month experience.

Clinical training

Clinical rotations in both the outpatient and ambulatory care settings include:

  • Medical oncology
  • Gynecological oncology
  • Pain and anesthesia
  • Physical medicine and rehabilitation
  • Radiation oncology
  • Pediatric oncology
  • Transplant medicine, including renal, cardiac, lung and liver
  • Elective rotations

Rotation schedule

A typical rotation schedule for the 12-month fellowship is:

Rotation Length
Hospice and Palliative Care Consultative Service Mornings for 12 months
Oncology Afternoons for 3 months
Gynecologic oncology Afternoons for 1 month
Radiation oncology Afternoons for 1 month
Intensive care unit Afternoons for 1 month
Physical medicine and rehabilitation Afternoons for 1 month
Transplant unit Afternoons for 1 month
Pain and anesthesia Afternoons for 1 month
Electives Afternoons for 3 months
Continuity clinic One day a week for 12 months
Nursing home Half-days for 12 months
Research Half-days two times a month

Didactic training

Coursework includes structured lectures by Mayo Clinic and Community Hospice faculty. You are responsible for approximately six lectures during your 12-month fellowship.

You also participate in monthly lectures hosted by faculty at Mayo Clinic's other campuses in Scottsdale, Arizona, and Rochester, Minnesota.

Research training

Your research opportunities at Mayo Clinic are outstanding. During the course of the Hospice and Palliative Medicine Fellowship, you design and complete a research project under close mentorship from one of our experienced clinician-researchers.

You learn about research through observation and participation in the design and conduct of ongoing clinical trials.


To ensure you gain proficiency and develop the corresponding technical skills, your performance is monitored throughout the Hospice and Palliative Medicine Fellowship. You are formally evaluated by your supervising faculty member after completing each clinical rotation, and then you meet with the program director to review these evaluations.

In addition, you regularly evaluate the faculty to ensure your educational goals are being met.

July 21, 2015