The Hospice and Palliative Medicine Fellowship Program at Children's Hospital Los Angeles is a one-year Accreditation Council for Graduate Medical Education (ACGME)-accredited fellowship that seeks to produce physicians who are experts in symptom management, medical decision-making and quality-of-life concerns for patients with life-threatening and life-limiting illnesses. Clinical training occurs primarily at our main campus, a 413-bed quaternary care facility. CHLA has been named one of the nation’s five best children’s hospitals by U.S. News & World Report, and it is the only pediatric medical center in California ranked by the publication in all 10 medical specialties each of the past five years. The Division of Palliative Medicine is integrated through all specialties in our medical center. We are excited to support a fellow through a one-year educational and growth process toward becoming an expert pediatric palliative care provider.
Curriculum Highlights
Children’s Hospital Los Angeles is home to one of the largest and busiest pediatric palliative care services in the country.
Inpatient Palliative Consult Service
Our fellows spend 6 ½ months with CHLA’s busy inpatient pediatric palliative care consultation service. We have a full interdisciplinary team made up of physicians, advance practice nurses, social workers and a psychologist. On average we see 500 new consults annually across all pediatric and young-adult ages and thousands of follow-up visits. Consults range from symptom management to exploring treatment goals in advanced illness and finding value-based, goal-concordant care.
Kaiser Permanente Los Angeles Medical Center also hosts our fellows for three weeks of training on its interdisciplinary inpatient palliative care consultation service, where they mainly care for adults.
Outpatient Palliative Care Clinic
Children’s Hospital Los Angeles has a robust outpatient clinic in which our fellows participate with the interdisciplinary team in a weekly half-day clinic in longitudinal care. We began our telemedicine pilot program in 2018, and now it is a well-established aspect of our care model, allowing us a better peek into the home life of our patients and their families.
Hospice and Home-Based Palliative Care
We have a strong collaboration with Providence Home Care and Trinity Kids Care (TKC). Our fellows spend five weeks with TKC and its pediatric-specific home hospice and home-based palliative care program, seeing on average 20 patients per week. Our fellows work closely with hospice Medical Director Glen Komatsu, MD. Our fellows also complete their hospice experience with five weeks at the adult hospice program to explore how their inpatient hospice unit works. They will also concentrate on how to provide total care for patients with a terminal illness in their homes, along with learning Medicare and Medicaid hospice rules and regulations as part of their rotation.
Long-Term Care and Inpatient Rehab
Fellows spend two weeks at All Saints Sub Acute Facility where they care for both pediatric and adult patients. The rotation is spent with an emphasis on the care of the pediatric patients while supervised by the Pediatric Medical Director, Dr. Sally Ward. Fellows also spend 2 weeks caring for patients in Children’s Hospital Los Angeles inpatient Acute Rehab hospital. The goals of these rotations are to learn about systems and financing of caregiving in the U.S. from infancy through adulthood. Fellows conduct family meetings in these settings to help coordinate care for patients who have functional impairment related to their health conditions.
Electives Rotations
Fellows choose three additional one-week clinical experiences in specialties that collaborate closely with palliative medicine. It is an opportunity to broaden their understanding of the care provided to our unique patients. Some options include: pediatric oncology and radiation oncology clinics, inpatient complex care in hospitalist medicine, radiation oncology, neurocritical care consultation service, and maternal-fetal medicine consultation service. The fellows also complete one week with the acute/chronic pain service during which they spend time with the Complementary and Integrative Medicine outpatient pain clinic.
Quality Improvement and Research
Our department has a strong quality improvement (QI) program that is based on the Institute for HealthCare Innovation (IHI) QI modules. The curriculum is passed throughout the year with a final project that can be used for Maintenance of Certification (MOC) credit. Our fellows are also able to use four weeks of elective time to work on a research or QI plan or other clinical or educational opportunities that support their growth toward future work success.
Leadership and Education Curriculum
Fellows participate in anesthesia/critical care medicine leadership curriculum in a collaborative learning environment with the other first-year fellows in our department. It is an opportunity to consider your personal strengths and how you would like to show up as a leader. Our fellows also participate in the pediatric fellows’ core curriculum, covering important topics from job-application considerations to the best ways of giving and receiving feedback. We also have a weekly Palliative Medicine Lecture Series covering symptom management, communications topics, journal club and more.
Well-Being
Medicine is practiced through a constantly changing environment and one where learning and practicing personal well-being is paramount to your success as a clinician. The Division of Comfort and Palliative Care consistently works to share the culture of well-being at work and integrate our fellows into all activities, such as reflections and recognitions at the start of all meetings. We also hold a monthly compassion-based case conference alternative with wellness check-ins as a full interdisciplinary team. We have integrated narrative medicine into our educational curriculum. We also support fellows attending a monthly wellness session, joined by the Critical Care fellows and supported by our head of Graduate Medical Education Wellness, Helene Morgan, MSW. We welcome well culture-affirming opportunities and support your exploration toward ensuring your work/life is harmonious.
Program Locations
- Children’s Hospital Los Angeles - Division of Palliative Care
- Providence Trinity Kids Care and Trinity Home Hospice
- All Saints Sub-Acute Facility
- Kaiser Permanente Southern California Palliative Medicine Service
Mentorship
- Career Development Mentor
- Well-being Mentor/Coach
- Scholarship/Research Mentor
Benefits
- Funding to attend one academic conference
- Reduced rate for covered parking
- Office space, computer, pager
- Textbooks and other resources available
- Salary minimums:
- Post Graduate Year 4: $78,531 minimum
- Post Graduate Year 5: $81,677 minimum
- Post Graduate Year 6: $84,712 minimum
- Post Graduate Year 7: $87,652 minimum
- Post Graduate Year 8: $90,952 minimum
- Post Graduate Year 9+: Please contact gme@chla.usc.edu
- Benefits include: Health and dental insurance; 14 days paid vacation plus six protected sick days; yearly educational stipend; monthly meal stipend; housing stipend; and 401(k) matching up to 3%
How to Apply
The Palliative Medicine Program is a part of the National Resident Matching Program (NRMP). Our program takes applications via the Electronic Residency Application Service (ERAS). If you are interested in applying for our fellowship program, you will need to apply through ERAS application process.
ACGME program number: 5400512116
NRMP program number: 1031540F0
We will be interviewing applicants in August, September and October.