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Education & Training

Curriculum


Blocks   

Rotation for Adult Program

1

Boot Camp

5

Inpatient palliative medicine consultation service

2.5

Home and inpatient hospice

1

Elective (Interventional Pain, Geriatrics, etc.)

1

Research/Quality Improvement Project

1

Long Term Care

1

Pediatric palliative care service

0.5

Pharmacology

 

Blocks   

Rotation for Combined Adult/Pediatric Program

1

Boot Camp

2

Inpatient palliative medicine consulation service

2.5

Home and inpatient hospice

2

Elective (Interventional Pain, Geriatrics, etc.)

1

Research/Quality Improvement Project

1

Long Term Care

3

Inpatient pediatric palliative medicine consultation service

0.5

Pharmacology


*Each block is 4 weeks for a total of 13 blocks

Continuity Clinic

Fellows have a ambulatory clinic weekly during which they will see a diverse patient population including patients experiencing the following serious illnesses: cancer, heart failure, lung disease, neurologic disorders, HIV, etc. For those fellows interested in the Adult/Pediatric track, fellows will spend 6 months in the Adult Palliative Care Clinic at OSU and 6 months in the Complex Care Clinic at Nationwide Children's Hospital.

Foundational Knowledge Rotations

  • Boot Camp - All fellows spend Block 1 together with the majority of clinical work focused on the James Cancer Center. This rotation is designed to orient the fellow to the hospital system and to key Palliative Medicine concepts through workshops, small group discussion, literature review and clinical teaching.
  • Pharmacology rotation - approximately mid-year, fellows spend 2 weeks with the Palliative Medicine pharmacist on a clinical inpatient service to deepen their knowledge on the pharmacology of symptom management (e.g. use of opioids in renal and/or hepatic dysfunction, pharmacologic options for management of delirium, anorexia/cachexia, insomnia, malignant bowel obstruction, etc.).

Inpatient Consultation Service Rotations

Fellows spend a total of 5 blocks on inpatient consultation services with an interdisciplinary team (including chaplain, social worker and pharmacist), an APN, an attending and often medical students and residents. The placement on inpatient consultation teams during the 5 blocks willdepend on the fellows' interests with a focus on providing comprehensive care including symptom management and delineation of goals of care for patients with serious illness. Adult/Peds track fellows will spend 3 months on the consultation service at Nationwide Children's Hospital. Adult track fellows will chose a combination of consultation services in the 3 OSU hospitals:

  • The James Comprehesive Cancer Center - fellows care for patients with cancer at all stages of disease and all levels of treatment including clinical trials. Fellows consult on patients with both solid and hematologic malignances including patients who will or have undergone a bone marrow transplant as well as patients with non-malignant hematologic illnesses such as sickle cell disease.
  • The University Hospital - fellows will care for a diverse patient population in the intensive care units (medical, surgical, neurological), Harding Psychiatric Hospital, Dodd Rehabilitation Hospital and on the general medical and surgical services.
  • The Ross Heart Hospital Service - fellows care for patients with advanced heart failure as well as patients receiving advanced heart therapies and undergoing high-risk procedures (e.g. LVADs, transplants, TAVR, ECMO).

Pediatric Palliative Medicine Rotation

Fellows provide care to children with complex palliative care needs in the following settings associated with Nationwide Children's Hospital: patient's homes (both palliative care and hospice), complex care clinics, and inpatient consultation. Adult track fellows will spend at least 4 weeks on this rotation. Adult/Pediatric track fellows will spend at least 3 months on the inpatient consultation service and 6 months in the Complex Care Clinic on a weekly basis.

Hospice Rotation

Fellows will spend a total of 2.5 blocks at Zusman Community Hospice within Wexner Heritage Village. Fellows participate in the care of hospice patients in conjunction with an interdisciplinary team in patients' homes, in the skilled nursing facility and/or in the inpatient hospice unit.

 

Long Term Care Rotation

Fellows spend 1 block at Ohio Health Hospice providing clinical care in the inpatient hospice facility (Kobacker Hospice house ) and occasionally at the skilled nursing facility in conjunction with an interdisciplinary team.

 

Elective

Fellows select from a large number of electives to allow further exposure to fields related to Hospice and Palliative Medicine. Some electives that have been chosen by past fellows include:

  • Hematology/Oncology
  • Congestive Heart Failure
  • Ethics
  • Medical Intensive Care Unit
  • Integrative medicine
  • Pediatric (inpatient and outpatient)
  • Geriatrics
  • Spiritual care
  • Interventional Pain

 

Scholarly Activity Rotation

Fellows spend 1 block focusing exclusively on their scholarly activities. Fellows complete a quality improvement project as a group with close supervision from the Palliative Medicine faculty and the Office of Quality and Patient Safety. In addition, fellows present a topic of interest at the Division of Palliative Medicine Grand Rounds after close supervision and mentorship on developing an effective lecture. Finally, fellows are strongly encouraged to work on another scholarly activity with close faculty supervision (e.g. a case report, a Fast Fact, literature review, presentations at local or national meetings).

 

Psychosocial Curriculum

Fellows participate in quarterly meetings with a PhD clinical psychologist to discuss clinical cases with a focus on psychosocial issues identified in clinical encounters. Topics covered during this time include bereavement, grief, depression, anxiety, PTSD, etc.

 

Billing Curriculum

Fellows are involved in didactics, small group discussion, and chart review and throughout the year designed to teach the components of a comprehensive palliative care consultation and integration of billing requirements.

 

Communication Curriculum

Fellows meet monthly for small group workshops that teach patient-centered communication strategies through simulated patient experiences. This also includes a 3-day intensive communication course at University of Pittsburgh.

 

Ethics Curriculum

Fellows learn to recognize and manage ethical issues in the practice of Hospice and Palliative Medicine through a reading list,  lectures and small group discussions. Fellows are encourage to participate in a monthly Clinical Ethics Case Conference.

 

Spirituality Curriculum

Fellows learn to screen for and address existential and spiritual distress for patients and their families who are facing serious illness.  Fellows participate in multiple workshops throughout the year to gain knowledge and skills regarding the spiritual needs of patients from major world religions with a particular focus on end-of-life care. 

 

Chemical Dependency Curriculum

Fellows develop basic knowledge and skills in caring for Hospice and Palliative Medicine patients with current and/or prior chemical dependency issues through longitudinal lectures, workshops, and precepted clinical care.

 

Clinician Educator Certification Program

In conjunction with their other subspecialty fellows in the Department of Internal Medicine, fellows attend monthly seminars on various topics that help to develop knowledge and skills in medical education. Fellows may opt to pursue higher certification by involvement in education-based workshops and scholarly projects.

 

Structured Learning Activities

Fellows have ample protected time for learning during their block rotations. Educational sessions occur weekly on Tuesday mornings from 8-11a.m. Fellows from the Ohio State University, OhioHealth and Nationwide Children’s Hospital participate in these sessions together to foster collaborative learning. 

The educational sessions include the following:

  • Ethics curriculum
  • Communication curriculum
  • Billing curriculum
  • Spirituality curriculum
  • Chemical Dependency curriculum
  • Leadership training
  • Journal club
  • Case conference
  • Division of Palliative Medicine Grand Rounds