Hematology-Oncology Hospice & Palliative Medicine Fellowship Track

The first year of the fellowship focuses on providing participants with a solid foundation of clinical knowledge and experience through high-impact educational conferences and longitudinal, outpatient-focused clinical training. Fellows will be paired with disease experts for more focused learning opportunities.

Year 1 of the fellowship includes: 

• Disease-focused half-day clinics in medical oncology, malignant hematology and classical hematology (7 half-day sessions per week, year-long)
  
  • Fellows are assigned longitudinally to work with a disease-specific faculty mentor in each of their disease-focused clinics on a given half-day each week over the course of the year.
  • Fellows assume primary responsibility of the patients for whom they care, in conjunction with their faculty mentor and supporting interdisciplinary team members.
  • Provision of care across the spectrum of cancer and survivorship, including active participation in our clinical trials program.
• Inpatient hematology/oncology consult service (4-5 weeks)
  • Fellows commence intermittent inpatient responsibilities during the second half of the academic year.
  • Inpatient hematologic/oncologic consultation is provided for a vast array of medical services in a tertiary care setting on BIDMC’s East and West campuses.
  • Fellows get rich exposure to hematologic/oncologic emergencies and consultative issues.
• Educational conferences (daily, year-long)
  
  • Read more about clinical conferences and meetings.
  • Integrated educational conferences in hematology/oncology and hospice palliative medicine
• Participation in the longitudinal career development process (year-long)
  
  • Professional development series: weekly conferences on topics relevant to career development (including finding a mentor, careers in hematology/oncology, scholarship pathways, independent funding, finding a job, etc.)
  • Team-based, longitudinal career advising
  • Biannual mentorship conferences with fellowship program leadership, including scholarship advisors
  • Annual Career Development and Scholarship Advisory Council meetings
• Vacation (3 weeks per academic year)

Following the comprehensive clinical experiences in clinical hematology/oncology in the first year of fellowship, trainees will focus on a combination of inpatient and outpatient clinical and didactic training in hospice and palliative medicine in their second year. Additionally, they will maintain a longitudinal clinic in hematology/oncology.

Years 2 of the fellowship includes: 

• Inpatient hematologic malignancies (8-9 weeks)
  
  • Intensive exposure to diagnosis, evaluation and management of patients with hematologic malignancies and related complications including: autologous and allogeneic hematopoietic cell transplantation and adoptive cellular therapies.
  • Fellows are supervised by expert faculty mentors.
• Longitudinal clinic in hematology/oncology (1 half-day per week, year-long)
  
  • Each fellow will define their patient panel and clinical focus, in accordance with their individual goals and supported by the fellowship program’s career development infrastructure.
• Inpatient palliative care (4 months)
  
  • Fellows will work with a unified interdisciplinary team (comprised of physicians, advanced practitioners, social work, spiritual care and pharmacists) to manage consult requests addressing symptom management, advance care planning and end-of-life care across general medical and subspecialty services.
  • This includes working with the innovative palliative oncology service at BIDMC, which sees hospitalized patients with cancer on a criteria-based referral model.
• Inpatient hospice (8 weeks)
  
  • Fellows will work closely with a robust interdisciplinary team at Care Dimensions, a leading nonprofit organization in the Greater Boston area. This includes experience in compassionate end-of-life care, advanced symptom management, and support for patients and families at the general inpatient (GIP) level of hospice care.
• Home hospice (4 weeks)
  
  • This includes home visits in conjunction with hospice nurses, the hospice medical director and other interdisciplinary team members.
  • Fellows will be involved in presenting patients at weekly interdisciplinary team meetings.
  • The didactic curriculum includes lectures on care for the dying patient, non-oral routes of medication administration and other hospice care topics.
• Pediatric palliative care (2 weeks)
  • Rotation at Boston Children’s Hospital to work with their advanced care team to provide advanced symptom management, complex medical decision-making, and comprehensive interdisciplinary support to children and families facing serious illness.
• Palliative care consultation in long-term care/rehab (3 weeks)
  
  • Fellows will participate in consultations for patients in the long-term care setting as well as the short-term rehab unit.
  • Specific experience includes assessing rehab patients who are referred following frequent hospital readmissions or a recent decline in function or medical status.
  • Fellows will work with the multidisciplinary team at Hebrew SeniorLife.
• Palliative care clinic (1 half-day per week, 6 months)
  
  • Longitudinal, ambulatory palliative care clinics at BIDMC or the Boston VA.
  • Ambulatory referrals commonly include pain, non-pain symptom management, advanced care planning and psychosocial support.
  • Fellows see assigned patients during each clinic session under the mentorship of hospice and palliative medicine faculty.
• Participation in the longitudinal career development process (year-long)
  
  • Professional development series: weekly conferences on topics relevant to career development (i.e., finding a mentor, careers in hematology/oncology, scholarship pathways, independent funding, finding a job, etc.).
  • Team-based, longitudinal career advising.
  • Biannual mentorship conferences with fellowship program leadership, including scholarship advisors.
  • Annual Career Development and Scholarship Advisory Council meetings.
• 2 months allocated to independent scholarship and professional development (learn more below)
• Vacation (3 weeks per academic year)

The final year of training will be largely reserved for pursuit of individual scholarship and professional development needs based on each fellows’ chosen career path. Trainees can pursue additional clinical experience in the form of electives based on interest and career goals.

Year 3 of the fellowship includes: 

• Longitudinal clinic in hematology/oncology (1 half-day per week, year-long)
  
  • Each fellow will define their patient panel and clinical focus, in accordance with their individual goals and supported by the fellowship program’s career development infrastructure.
• Clinical electives (1-4 week blocks)
  
  • Radiation oncology
• Laboratory medicine
  
  • Hematopathology
  • Pathology
  • Cytogenetics
  • Coagulation
• Transfusion medicine
• Community-based hematology/oncology, BID Needham
• Hospice and Palliative Medicine electives, including:
  
  • Spiritual care and social work immersions
  • Addiction medicine
  • Chronic/Interventional pain management
  • Geriatrics
• 11 months allocated for independent scholarship and professional development (learn more below)
• Vacation (3 weeks)

Time for initiation and pursuit of independent scholarly project(s) of each fellow’s choosing; this work will be continued longitudinally and with mentored oversight. This includes time for writing IRB proposals, research protocols, manuscripts and grants, as well as time for pursuing coursework or meetings/collaborations relevant to the individual’s professional development needs.

Years 2 and 3 of fellowship include: 

• Multiple defined pathways* for deliberate professional development are offered.
  
  • Translational/laboratory investigation: Mentored experiences with application for career development awards (NIH, ASCO, ASH), presentations at locoregional and national/international conferences and meetings, and seminars in grant and manuscript writing. Formal didactic/course work opportunities include: Harvard Catalyst Models of Disease Boot Camp; Harvard Catalyst Clinical and Translational Research Academy; Harvard-wide Vascular Biology Seminar Series; Hemostasis and Thrombosis Research Seminar Series; Analytical & Quantitative Light Microscopy, MBL, Woods Hole, MA; and the Frank Epstein Research Society (“K” club).
  • Clinical investigation: Mentored experiences that include developing and writing a clinical trial protocol, initiating a clinical research study, big data outcomes research and others. This includes preparation for presentations at locoregional and national/international conferences and meetings, seminars in grant and manuscript writing. Formal didactic/course work opportunities include: Harvard School of Public Health Program in Clinical Effectiveness, Harvard Catalyst Models of Disease Boot Camp, Harvard Catalyst Clinical and Translational Research Academy, and others. The career development strategy includes preparation and mentorship to apply for career development awards (NIH, ASCO, ASH).
  • Medical education: Mentored experiences aimed at developing rigorous skills in curriculum development, instructional design and teaching, evaluating educational outcomes, and evaluations and feedback. This includes preparation for presentations at locoregional and national/international conferences and meetings. Formal professional development opportunities include: participation in the Clinician Educator Track for Subspecialty Fellows, BIDMC Academy of Medical Educators, HMS Academy of Medical Educators, ASH Medical Educators Institute and others.
  • Patient safety and quality improvement: Mentored experiences involve comprehensive training through participation in Divisional and Departmental Patient Safety Committees, leadership of the ASCO Quality Oncology Practice Initiative (QOPI), leading and planning Divisional Morbidity, Mortality and Improvement (MM&I) Conferences, and engaging in mentored QI projects within the hospital or larger network. Formal course work/didactics include the Harvard Medical School Fellowship in Patient Safety and Quality Improvement.
  • Community-based practice: Mentored experiences with emphasis on comprehensive and broad-based training in hematology/oncology to facilitate expert care and clinical innovations in community-based settings. Professional development in this pathway includes curated clinical experiences both in disease-focused clinics and tumor boards at BIDMC and broad-based clinical care in partnership with expert faculty mentors situated in our community satellites. Mentored experiences include developing expertise in clinical/hospital administration, patient safety and quality improvement, and clinical trials, among others. Both finite elective and longitudinal options for community-based training are offered.
• *These pathways are not mutually exclusive and can be selected (major focus/minor focus) based on individual career interests and objectives. Additional elective experiences can be selected to maximize support for each trainee’s career pathway.

For more information about the clinical training experiences and didactics included in Year 2, please visit the Hospice and Palliative Medicine Fellowship page.