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The two-year training program consists of 12-months of clinical training and 12 months of research. During your clinical training, you will:
- 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 to 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 and ethics consult service.
- Demonstrate a working proficiency in ethical principles, including autonomy, beneficence, non-maleificence, justice, informed consent, euthanasia, decision-making capacity, substituted judgment, utility, futility and benefit-risk assessment.
- 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 WHO 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 Hospice and 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 (e.g., how to avoid burnout and maladaptive coping mechanisms.)
- Lecture and teach medical students, nurses and other members of the health-care team regarding the special aspects of palliative medical care; (i.e., "spread the word" by being an advocate of Hospice and Palliative Medicine in the community, to promote the benefits of, and to increase access to Medicare hospice benefits).
- Learn and apply the Medicare/Medicaid qualifications/requirements/eligibility rules and regulations; as well as managed care and HMO mandates.
- Learn empathic interviewing techniques.
- Take a spiritual history and be sensitive to cultural variations.
- Incorporate patient's cultural, spiritual and experiential perspectives to design an individualized care plan.
Clinical Training
Clinical rotations in both the outpatient and ambulatory care settings include:
- Medical oncology
- Gynecological oncology
- Pain/anesthesia
- Physical medicine and rehabilitation
- Radiation oncology
- Pediatric oncology
- Transplant medicine (renal/cardiac/lung/liver)
- Elective rotations
Rotations
The following shows the typical rotation schedule for the program:
| Year One |
| Required rotations |
Length |
| Palliative Care Consult Service |
3 months |
| Anesthesia Pain Outpatient Clinic |
1 month |
| Anesthesia Pain Inpatient Service |
1 month |
| Hospice |
3 months |
| Inpatient Oncology Service |
1 month |
| Continuity Clinic |
12 months
(concurrent with other rotations)
|
| Elective rotations (must choose three) |
Length |
| Psychiatry |
1 month |
| Geriatrics |
1 month |
| Nursing Home |
1 month |
| Physical Med and Rehabilitation |
1 month |
| Pediatric Palliative Care |
1 month |
| Nephrology / End stage dialysis |
1 month |
| Chronic Ventilator unit |
1 month |
| Dementia unit |
1 month |
| Congestive Heart failure Service |
1 month |
| Ethics Consult service |
1 month
(concurrent with other rotations)
|
| Year Two |
| Rotation |
Length |
| Research |
12 months |
| Continuity Clinic |
12 months (concurrent) |
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Year two offers a unique opportunity for unlimited research in Palliative Care. Mayo Clinic is a world leader in clinical research and has world leaders in study design and methodologies. Our faculty includes leaders in the International Society for Quality of Life (ISOQOL), and organization dedicated to the study of Quality of Life in all medial care. The graduate school also offers programs in clinical research, potentially leading to a Masters Degree or added certification.
Didactic Training
Clinical conferences, seminars, small discussion groups, journal clubs and one-on-one instruction are an integral part of Mayo Clinic's Hospice and Palliative Medicine Fellowship Program. Behavioral medicine will be integrated throughout all two years of your training.
Weekly conferences and monthly half-day seminars will cover primary care topics, including discussion of ethical dilemmas faced by physicians in training.
Case Studies/Mortality and Morbidity Conference
You will prepare and present the pertinent information of an interesting case, conduct an in-depth discussion of that case, and supply a current bibliography.
Research Training
Your research opportunities at Mayo Clinic are outstanding. During the course of this fellowship, you will design and complete a research project under close mentorship from one of our experienced clinician-researchers.
You will learn about research through observation and participation in the design and conduct of ongoing clinical trials.
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