The 2023 APP Palliative Medicine Fellowship Program
A 12-month interprofessional postgraduate program for advanced practice providers (APPs), our 2023 Palliative Medicine Fellowship Program at AdventHealth Orlando will give a deeper understanding of palliative medicine and whole-person care.
Nationwide, there's a growing demand for educated and compassionate palliative care providers. We're meeting that need by providing post-graduate fellowships for nurse practitioners and physician assistants.
The mission of our Palliative Medicine Fellowship Program is to grow the clinical, academic and patient experience skills you'll need to succeed as part of the next generation of APPs in AdventHealth. In our fellowship, you'll complete a dedicated year of training and education to prepare for a palliative medicine practice.
Grow Your Skills in Palliative Medicine
Palliative Care is a medical specialty focused on maximizing quality of life through the relief of symptoms during all stages of a serious illness. It is appropriate at any age and can be provided along with curative and life-prolonging treatment. Providers can help treat symptoms like pain, constipation, nausea, dyspnea and anxiety while also assisting in ensuring goals of care for patients and families align with medical treatment.
In our postgraduate fellowship program, you’ll gain:
Knowledge in the assessment and management of complex pain-related and non-pain-related symptoms at a sub-specialty level
A deeper understanding of the complex interaction between serious medical illness and each patient’s goals
Practice performing spiritual, psychosocial and cultural assessments with referrals to appropriate interdisciplinary members
Clinical exposure in hospice, oncology and end-stage conditions
Weekly didactics with physician fellows and one-on-one supervision
Varied rotations at AdventHealth hospitals in the Orlando area
Upon completion of the program, fellows will receive a certificate documenting successful completion and will have the skills and knowledge to successfully pass the Advanced Certified Hospice and Palliative practitioner examination.
About Our Program
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Curriculum
Our program goals include:
Gather, synthesize and apply comprehensive and accurate clinical information from all sources pertaining to the medical care of outpatient/inpatient palliative care patients
Recognize the presentation, management, disease trajectories and various treatment modalities (chemotherapy, hormonal therapy, immunotherapy, surgery, radiation) for common solid and hematologic malignancies
Develop competence in pain management for cancer and non-cancer pain for outpatient/inpatient palliative care patients, with a focus on safe opioid prescribing (checking PDMPs, obtaining prior authorizations, documenting prescription refills, fielding other patient requests), monitoring opioid risk scores, screening for substance use disorder and current substance use/misuse, and non-opioid analgesics, adjuvant analgesics and non-pharmacologic approaches
Develop competency in assessment and management of common non-pain symptoms for palliative care outpatients/inpatients, including, but not limited to:
Nausea and vomiting (chemo-induced, malignant obstructions, other causes pertinent to cancer)
Dyspnea
Insomnia
Fatigue
Depression and anxiety
Existential suffering and grief
Anorexia/weight loss
Demonstrate knowledge of alternate routes of administration for medications when patients are unable to take medications orally
Develop skills in working with an IDT in all aspects of patient care
Develop skills in communicating/collaborating with oncology providers (hematology/medical oncology, surgical/gynecologic oncology) and other providers (primary care, surgeons, other specialists) while patients are going through cancer treatment
Demonstrate accurate and comprehensive understanding of psychological stressors and disorders experienced by patients and families facing life-threatening conditions and describe appropriate clinical assessment and management, including the ability to assess, counsel and support patients and families around the burdens of caregiving and make appropriate referrals around fiscal issues and legal concerns
Curriculum (Continued)
Our program goals also include:
Demonstrate knowledge of local laws and regulations related to the following areas: medical marijuana, physician aid in dying and opioid agonist therapy for opioid use disorder (methadone and buprenorphine)
Determine relevant scholarly questions and pursue relevant scientific inquiry, particularly regarding topics in outpatient palliative care and supportive oncology
Effectively communicate across care settings (outpatient, inpatient, hospice) for patients receiving palliative care and demonstrate knowledge of the transitions between these care settings
Develop competence in discussing end-of-life care in the outpatient/home setting
Gain experience in related specialties to outpatient palliative care, such as physical medicine and rehabilitation, hematology/medical oncology, gynecologic oncology, radiation oncology and wound care
Demonstrate care that is respectful of age, developmental stage, gender, sexual orientation and cultural practices
Maintain a safe and competent practice, including self-evaluation and continuous learning
Maintain comprehensive, timely and legible medical records
Demonstrate care that is cost-effective and represents best practices
Demonstrate the capacity to reflect on personal attitudes, values, strengths, vulnerabilities and experiences to optimize personal wellness and capacity to meet the needs of patients and caregivers
Fellowship Rotations
In our fellowship program, rotations include:
Inpatient Palliative Care - Core
Outpatient Palliative Care - Core
Oncology - Core
Pulmonary Hypertension - Core
Intensive Care Unit - Core
Heart Failure - Core
Chaplaincy - Core
Inpatient Hospice - Elective
Outpatient Hospice - Elective
Music Therapy/Child Life Therapy - Elective
Elective of Choice - Inpatient Palliative Care, Outpatient Palliative Care, Oncology, Pulmonary Hypertension, Music Therapy/Child Life Therapy, Heart Failure, Chaplaincy, Intensive Care Unit, Inpatient Hospice, Outpatient Hospice, Research, Leadership/Administrative
Preceptors and Mentorship
Every rotation fellow will be assigned an SDCP preceptor to help reach their block learning objectives. Palliative Care is supported by an interprofessional team, including Nurse Practitioners, Licensed Clinical Social Workers, Nurses, Physicians and Chaplains. Fellows have mentorship opportunities from any member of the team.
Completion of Fellowship
As part of weekly RD, fellows will be prepared to sit for the Advanced Certified Hospice and Palliative Nurse (ACHPN) examination. Upon three months of fellowship completion, fellows are expected to sit for the ACHPN exam. Fellows will receive a non-ACGME accredited certificate of completion from AdventHealth. Full-time employment offers are contingent upon position availability.
Important Dates
January 1 to July 15: Program Applications Open
August: Interviews
September: Applicants Selected and Notified
January 2023: Fellowship Begins
Interview Process
Candidates will be notified within two weeks of application submission if invited for an interview. The interview day will consist of program orientation, committee interview, individual interview and a tour of the AdventHealth Orlando campus.
The interview committee is composed of APPs, physicians and leadership in Palliative Care. The committee will be considering these core competencies:
Interpersonal communication skills
Professionalism
Medical knowledge
Patient-care experience
Empathy
Resilience
Growth mindset
It is the candidate's responsibility to arrange travel and lodging for the interview day.
Competitive Fellowship Benefits for You
We want to ensure that it’s rewarding for you to expand your expertise with us. That’s why we’ve made these benefits part of our fellowship program:
Competitive fellowship salary for 12 months, then transition to a full nurse practitioner salary
Employment status to include benefits (health insurance, malpractice, CME days and paid leave days)
Meet Our Program Team
With a wealth of knowledge and combined decades of experience, our fellowship program team is dedicated to helping you grow your career in palliative medicine.
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We welcome your application for our fellowship program in palliative medicine. Online applications for our 2023 program are now open and will be closing on July 15, 2022. Applicant interviews will be conducted throughout August, with applicants selected and notified in September. The fellowship program begins in January 2023.
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