You will spend three blocks of time on the Inpatient Palliative Care Consultation Service at Saint Marys and Rochester Methodist campuses. During the inpatient consultative blocks, you are an integral part of the interdisciplinary team providing consultative subspecialty palliative care services to patients in the acute setting. Consultation Service team members include board-certified consultants, advanced practice clinicians, nurses, social workers, pharmacists, chaplains, and music therapists.
The inpatient palliative care service is located at Mayo Clinic Hospital, Methodist Campus, and is a primary service addressing complex symptoms in those with serious or life-limiting illnesses.
On this service, you will work closely with members of the interdisciplinary team to meet the complex needs of the patients and provide total person care. In addition, you will liaison with members of other subspecialty teams to ensure that patients receive goal concordant care within the limitations of their illness.
Your first two blocks on IPCS are comprised of 8 and 12-hour day shifts with a weekend assigned each block. The final block hours will include 12-hour night shifts. During night shifts, fellows assume primary responsibility for the service pager and are the initial point of contact for patient care issues that arise. During this block, you will have a supervising IPCS advanced practice clinician on site who is in a "mentor" role, available for complex issues that arise and other collaboration as needed.
You will see patients two full days per month in the Palliative Medicine Clinic. In this clinic, we provide patients longitudinal subspecialty palliative care in addition to acute or urgent symptom management needs.
The outpatient practice serves patients within the entire spectrum of serious illnesses including, but not limited to:
- Cancer
- Heart failure
- COPD and pulmonary fibrosis
- Dementia
- Stroke
- Renal failure
- Multimorbidity
The Palliative Care Clinic experience provides the opportunity to follow patients during transitions of care from outpatient to inpatient and hospice as the clinician of record.
In addition to our free-standing palliative medicine clinic, we also have an embedded clinic within neurology as well. You will spend some of your clinic days in this clinic, allowing you to experience the benefits and drawbacks of both types of outpatient palliative care environments as well as foster professional relationships with referring clinicians.
You’ll spend time with the Mayo Clinic hospice team developing symptom management plans, participating in the recertification process, and assisting with the complex medical decisions patients and their families encounter as they near the end of life. Additionally, fellows will spend time with all interdisciplinary specialties, gaining additional insight into the expertise of each discipline as pertains to patients receiving hospice care.
While on the integrated hospice rotation, you will be paired with a physician medical director providing acute hospice care needs. In addition, you will gain deeper understanding of the nuances of hospice certification, recertification, and other critical elements as the medical director provides that impact the hospice care referral process.
While on the community hospice rotation, you will be paired with a hospice trained advanced practice clinician providing hospice care in rural community settings outside of Rochester. During this rotation, you will gain insight into the care needs and complexity of home-based hospice care, which is largely provided by the close friends and families of enrolled patients. Through this experience, you will gain invaluable knowledge that will help guide hospice discussions throughout your career when caring for individuals encountering their final stages of life.
You are provided two days per month to complete scholarly activities. These include honing academic skills through a combination of online classwork, self-guided education, and participation in live didactics with fellows across all three Mayo Clinic sites.
Additionally, you will be completing a mentored group quality improvement project from conception to dissemination in collaboration with physician co-fellows.
The outpatient pain rotation encompasses a wide array of cancer and noncancer-related pain management, including somatic and neuropathic pain management using opioids, adjuvants, and interventional procedures.
During this rotation, you will spend time with advanced practice clinicians learning the approach and techniques for the management of complex, chronic pain. In addition, you will spend time with experts learning the nuances of intrathecal pumps for complex pain.
There is also the opportunity to observe interventional pain procedures on an individual basis.
You will spend a half block with our pediatric palliative consult service, also known as Comprehensive Pediatric and Adolescent Support Services (ComPASS). During this rotation, you will participate in both inpatient and outpatient pediatric visits at Mayo Eugenio Litta Children’s Hospital.
In addition, you will spend time with the pediatric bereavement coordinator and child life specialists to learn about childhood development and how it relates to illness and grief responses.
You’ll spend a half block rotating with a variety of non-clinician palliative team members to better understand the roles of our colleagues and how best to utilize their expertise in the care of palliative care patients. This includes time with our palliative care social workers (both inpatient and outpatient), nurses, music therapists, chaplains, and pharmacist.
During this rotation, you will spend time with an advanced practice clinician who provides subspecialty management of complicated wounds in the acute setting. Fellows will learn different approaches to wound management as well as considerations for wound management in the outpatient settings for patients who are pursuing illness-directed or comfort-directed plans of care.
You will spend time with a radiation oncology advanced practice clinician who provides comprehensive care, radiation specific assessment and treatment planning to learn symptom management and patient care approaches unique to the patient undergoing radiation.
Electives are available in nearly every specialty at Mayo Clinic that might be of interest to our fellows. You can also use elective time for research.