Palliative Medicine and Hospice Fellowship
Palliative Medicine & Hospice Interdisciplinary Fellowship
The Division of General Internal Medicine and Geriatrics at Oregon Health & Science University and the Portland Veterans Affairs Medical Center offer an ACGME-accredited, truly interdisciplinary, one year fellowship in Palliative Medicine and Hospice located in the beautiful Pacific Northwest. Our mission is to provide fellows with an interdisciplinary approach to compassionate practice across the patient care spectrum.
Fellows are involved in the care of veteran, academic and community-based patients. They learn consultative skills, provide direct management of care in an inpatient hospice unit, work in a home hospice setting, participate in multi-disciplinary outpatient clinics, a long-term care setting, and have focused training experiences in pain clinic, chaplaincy, radiation oncology, pediatrics, and critical care. Fellows also receive one month of selective time. Additional curricular sessions involving communication skill development and formal ethics training occur throughout the year. A scholarly project and quality improvement or patient safety activity are expected and mentored. Working within interdisciplinary teams is an integral part of this fellowship. Fellows have opportunities throughout the year to teach medical students, interns, residents and interdisciplinary team members.
This training program prepares physicians to competently work in both palliative care and hospice settings. Graduates work as inpatient/outpatient palliative medicine consultants, hospice medical directors, provide administrative/clinical leadership on inpatient units, and have started new programs/services across the state, in addition to providing faculty support to various training sites. Graduates are eligible to sit for the Hospice & Palliative Medicine board exam.
Two physician fellows are chosen each year, as part of our interdisciplinary training program, which also involves nurse, social work, psychology and chaplain trainees. Physicians who have successfully completed an Internal Medicine, Family Medicine, Emergency Medicine, or Neurology residency are welcome to apply. Mid-career physicians with this training are also encouraged to apply. Physicians from other co-sponsoring boards will be considered based on their particular prior training and work experiences.
Faculty includes physicians from Internal Medicine, Critical Care, Anesthesiology, Geriatric Medicine, Pediatrics, Radiation Oncology and Psychiatry. Interdisciplinary faculty includes nurse practitioners, chaplains, social workers, clinical nurse specialists, psychologists, and clinical pharmacists. The faculty provides mentoring to develop strong clinical and teaching skills. Some faculty members are also grant-funded researchers. The core faculty is board-certified in Hospice & Palliative Medicine.
Multiple conferences are available to the fellows with protected time to participate. Weekly interdisciplinary didactic sessions focused on topics pertinent to clinical and scholarly aspects of hospice and palliative medicine are provided. Attendance at rotation-specific conferences is expected. A monthly city-wide palliative care conference is offered on a rotating basis at training sites across Portland. A collaborative state-wide palliative care conference is held each year. Fellows are encouraged to attend grand rounds, system-based morbidity & mortality conferences and special lectures as rotations allow.
Fellows are also encouraged to apply to our Clinical Scholars program, which includes topics in professional development and career advancement, theories of learning, clinical and didactic teaching methods and curriculum development. If accepted into the program, they are given protected time to attend courses three hours each week from September - June at OHSU.
Our fellowship program is participating in the National Residency Matching Program. Interested candidates can apply to our program through ERAS to access the Match, beginning in May/June of the year prior to their intended start date. Interviews are scheduled August through October.
Palliative Medicine Core Faculty
Dr. Nora Tobin is a Clinical Associate Professor of Medicine and the Medical Director of the ACGME-accredited Hospice/Palliative Medicine fellowship at the Oregon Health & Science University. She is a senior internist with sub-specialty board certification in both Geriatric Medicine and Hospice/Palliative Medicine. She served for five years in the dual role as Section Chief of Geriatrics and director of the Geriatric Medicine fellowship program at the Portland VA Medical Center before focusing her career in Palliative Medicine in 2001. She also staffs the Portland VAMC Palliative Care Consult team and provides regional leadership to Palliative Care Programs at all VA facilities across the Pacific Northwest. She is an active clinician-educator involved in medical student, resident, and fellow training and curriculum development.
Erik K. Fromme, MD, MCR, FAAHPM is a full time palliative care physician and Associate Professor of Medicine, Nursing, and Radiation Medicine at OHSU. Dr. Fromme attended the University of Virginia College of Arts and Sciences, the University of Oklahoma College of Medicine, OHSU Internal Medicine Residency, Johns Hopkins University General Medicine Fellowship, and Harvard Medical School/Massachusetts General Palliative Care Fellowship. He also completed Schwartz Fellowship in Pastoral Care at Mass General Hospital, a Masters in Clinical Research at OHSU, and is currently enrolled in the Interdisciplinary Ethics Fellowship at OHSU. Dr. Fromme is the Medical Director of the OHSU Palliative Medicine and Comfort Care Team which won the 2009 Circle of Life Award from the American Hospital Association. He is also an Assistant Director of the OHSU Center for Ethics in Health Care. His research interests include computerized approaches to cancer symptom management, Physician Orders for Life Sustaining Treatment (POLST), and health services and quality of life research in palliative care.
Linda Ganzini, MD, MPH is Director of the HSRD Research Enhancement Award Program at the Portland VA where she is also Director of the Interprofessional Palliative Care Fellowship. She is a Professor of Psychiatry and Medicine at Oregon Health and Science University where she is also Director of the Geropsychiatry Fellowship Program and a Senior Scholar at the Center on Ethics in Health Care. She completed her psychiatry training at OHSU, her geriatric medicine fellowship training at the Portland VAMC, and received a Masters of Public Health with emphasis in epidemiology and biostatistics from OHSU in 2003. She was a Project on Death in America Faculty Scholar. She has active research grants from the VA and from private foundations, including studies to examine the prevalence of mental disorders in hospice patients, and a randomized trial of methylphenidate for depressed cancer patients in hospice. She received a VA New Clinical Initiative grant to form the Portland VA palliative care consultation team and examine its outcomes. Her research on the Oregon Death with Dignity Act has been published in the New England Journal of Medicine and JAMA.
Dr. Jocelyn White graduated from Wellesley College in 1983 and New York University School of Medicine in 1987. She completed her training in Internal Medicine at Good Samaritan Hospital in Portland, Oregon. She was Chief Resident in 1990-91 and a fellow in General Internal Medicine at Oregon Health and Science University from 1990-1992 during which time she also completed a certificate in Health Care Ethics at the University of Washington. She has been a member of the Faculty of the General Internal Medicine Residency Training Program at Legacy Health System in Portland since that time, giving her the chance to teach residents, students, fellows, physicians and staff.
Dr. White has been a member of the Clinical Ethics Committee since 1989, serving first as its chair and then as Medical Director of Clinical Ethics for the Legacy Health System from 2000-2004. In 1998 Dr. White joined Legacy's pain initiative and helped to create end-of-life pain resources for Legacy. Her efforts and those of many others have resulted in Legacy's Palliative Care Program that is fully integrated with Legacy Hospice Services. Dr. White now serves as Medical Director of Palliative and Hospice Care. She has been a member of the faculty of the Interprofessional Palliative Care Fellowship of the Portland Veterans Administration Medical Center since its inception. Dr. White is on the editorial board of the Journal of Palliative Medicine.