Curriculum

The one-year training program consists of 12-months of clinical training, complemented by research experience. 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 palliative medicine.
• Coordinate and perform bereavement evaluation and follow up.
• Demonstrate cost-effective symptom evaluation and management.
• Extensive Hospice experience including working on an Interdisciplinary team.
• 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 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:

• Hospice of the Valley
• Inpatient Consultation Service
• Inpatient Hospice
• Elective rotations
  - Hematology/Oncology
  - Pain Service
  - Cardiology
  - Pulmonary Clinic
  - Pediatric Palliative Care
  - Research
  - Neurology/ALS Clinic

Rotations
The following shows the typical rotation schedule for the program:

Didactic Training
Clinical conferences, seminars, small discussion groups, journal clubs and one-on-one instruction are an integral part of Mayo Clinic's Palliative Care Medicine Fellowship Program. Behavioral medicine will be integrated throughout the year 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.

Also see:

• Research Training at Mayo Clinic