Clinical Rotations

• Inpatient Hospice – minimum 4 weeks
• Hospice Homecare – minimum 4 weeks
• Hospice Medical Director – minimum 2 weeks

We prioritize broad hospice exposure for our fellows across 3 different hospice agencies. These represent a spectrum of size and setting, national versus local institutions, and for profit versus non-profit. Fellows will gain extensive experience managing hospice and palliative care patients through time spent with the Connecticut Hospice, the first hospice in the United States, as well as VITAS Hospice based in Waterbury, CT and Middlesex Hospice and Palliative Care based in Middletown, CT. Fellows will participate in a minimum of 25 hospice home visits, interdisciplinary team meetings, daily rounds, administrative meetings, and other activities with hospice team members depending on the setting.

• West Haven VA Palliative Care – minimum 3 weeks
• Connecticut Children's Medical Center - minimum 2 weeks
• Yale New Haven Hospital Palliative Care – minimum 14 weeks
• Yale New Haven Hospital Radiation Oncology/Acute Pain Service – minimum 2 weeks
• Yale New Haven Hospital Addiction Medicine Service – minimum 2 weeks

Fellows will spend significant time on interdisciplinary inpatient palliative care consultation teams in both adult and pediatric hospital settings with a diverse spectrum of serious illness diagnoses, patients, and trajectories. They will also get exposure to addiction medicine, inpatient radiation oncology, and acute pain consultation services with a focus on the relevance to their palliative care practice.

• Yale New Haven Hospital Palliative Care Clinic – minimum of 26 half-days over the year

Fellows care for patients in the palliative care ambulatory setting under the close supervision of the palliative care faculty with patients largely referred from Smilow Cancer Center. Fellows will follow new patients longitudinally in clinic as well as across settings if the patients are admitted to the hospital, a long-term care facility, and/or hospice.

• Grimes Center (part of YNHH system) – minimum 2 weeks
• Middlesex Hospice and Palliative Care – minimum 2 weeks

Fellows will learn how to provide palliative care for frail older adults residing in long-term care and receiving short term rehabilitation in the Skilled Nursing setting at Grimes Center. They will also experience the continuity of care for patients with differing needs in the serious illness course in an inpatient combined palliative care and hospice unit at Middlesex Hospice and Palliative Care in Middletown, CT.

• Elective time – 4 weeks

Elective experiences are available in inpatient and outpatient settings and can be tailored to fellow interests and future career plans. We continue to create new electives. Elective time may also be spent in returning to one of the core rotation sites for additional training. Away electives of a maximum of 4 weeks may be explored, but require prior approval and pre-planning.

Past Fellow Electives: YNHH Medical Subspecialty Clinics (palliative care in hepatology, cardiology/VAD, pulmonary, and renal clinics, and dialysis unit), Leadership, Bioethics, Pharmacology, Psychosocial and Spiritual Care, YNHH Neonatal and Pediatric ICU, YNHH Medical ICU, VA Geriatrics Homecare, VA Geriatrics Consults, and YNHH Hematology Consults