| | Lombardi Cancer Center Fellowship Program In Palliative Care Medicine
Andrew Putnam, MD, Assistant Professor, Fellowship Program Director, Palliative Care Program Background
Palliative Care has been defined as the combination of active and compassionate therapies intended to comfort and support individuals and their families who are living with, or dying from, a progressive life threatening illness, or are bereaved. Palliative care is, optimally, an interdisciplinary endeavor and “palliative medicine” refers to the aspects of this specialty that are practiced by physicians. This program has been developed by the Palliative Care Program at Lombardi Cancer Center in collaboration with experts from both within Georgetown University Medical Center and in community-based programs to provide educational opportunities for physicians to train in the clinical and research aspects of this field.
Educational Program
This program is a sub-specialty program in palliative medicine that will provide training and experience at a sufficient level for the physician to acquire the competency of a specialist in this field. As there are no structured guidelines for palliative medicine training in the United States, this program has been developed based on existing models in this country and others. Guidelines for training in this field are evolving and the fellowship has been designed to be able to meet the requirements that are likely to be proposed by the American Academy of Hospice and Palliative Medicine and the American Board of Internal Medicine.
The fellowship program will involve an initial year of clinical palliative medicine with training occurring in a variety of environments including acute inpatient and outpatient care, and hospice care. The possibility of a second year of the fellowship exists to focus on the fellow’s elective areas of interest and on a palliative care research project.
To be eligible to participate in the fellowship program physicians must have undertaken training in hematology/oncology or in an aspect of medicine that is related to palliative care. Examples of such aspects of medicine include, among others, internal medicine, rehabilitation, pediatrics, family medicine, and infectious diseases.
The program will include opportunities to observe and manage patients with a wide variety of conditions on an inpatient and outpatient basis and in the home care setting. The fellow will be given opportunities to assume continuing responsibility for acutely and chronically ill patients receiving palliative care.
The program curriculum will emphasize the development specific skills related to palliative care. With this intent, the program has been designed to educate fellows in the following broad areas. - Assessment of complex medical problems related to severe medical illness
- Assessment of symptoms and distress in patients and families
- Basic physiologic processes associated with common physical symptoms, including, among many others pain, fatigue, and nausea.
- Psychiatric disorders associated with advanced illness
- Practical needs of patients and families living with advanced illness
- Cultural and ethical concerns that commonly exist within the context of advanced illness
- Treatment and intervention strategies for the alleviation of physical and psychological distress
- The function of the interdisciplinary team approach to care and the respective roles of individual team members
- A variety of approaches to promoting well-being for patients and families/caregivers living with advanced illness
- Comprehensive treatment of the imminently dying patient
- Bereavement process and interventions directed at assisting families and caregivers
- Outcomes assessment in palliative medicine
- Research methodologies related to palliative medicine
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