Hospice and Palliative Medicine Fellowship

Fellows spend 6 ½ months training on the inpatient pediatric palliative consultation service at Children’s Hospital Los Angeles, which is supported by a full interdisciplinary team.  The team is made up of physicians, Advance Practice Nurses, social workers, and a psychologist. We see on average 500 new consults annually across all pediatric 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. Fellows also spend 3 weeks training on the inpatient palliative consultation service at Kaiser Los Angeles Medical Center where they participate mainly in the care for adults.

Fellows spend 10 weeks on the home visit rotation with Trinity Kids care and Trinity home hospice. The fellow spends 5 weeks with the home pediatric palliative/hospice service and 5 weeks with the adult home hospice. Fellows carry an average census of 20 patients during the time with Trinity. The fellow works closely with the hospice medical director Dr. Glen Komatsu. They concentrate on how to care for patients with a terminal illness in the home with symptom management and home family meetings. They will also learn all Medicare and Medicaid hospice rules and regulations as part of the rotation.

Fellows spend 1 month in long term care. This is split between 2 weeks in pediatric acute care rehab at Children’s hospital Los Angeles, 2 weeks at a subacute facility that cares for both pediatric and adult patients. The goal is to learn about systems and financing of caregiving in the United States from infancy through adulthood. Fellows also conduct family meetings in this setting to help coordinate care for patients who have functional impairment related to their health conditions.

Fellows join our weekly interdisciplinary longitudinal Ambulatory palliative clinic at Children’s Hospital and also participate throughout the year in the outpatient integrated palliative care/cardiology clinic, integrated palliative care/oncology clinic and perinatal consultation clinic.  Patients and families are seen for symptom management, psychosocial support and advance care planning. Some of the appointments are completed through Telehealth allowing us a portal into our patient’s home life.

Fellows choose 3 (1 week) experiences in the following departments at Children’s Hospital Los Angeles: pediatric oncology clinics, inpatient complex care in hospitalist medicine, radiation oncology, Neuro-Critical care consultation service, maternal fetal medicine consultation service. The fellow will complete 1 week with the acute and chronic pain service and spend time with the Complementary and Integrative Medicine outpatient pain clinic.

Fellows have 1 month elective opportunity, which may include research or other clinical or educational opportunities that support their growth towards their future work success.

Fellows participate in the Anesthesia/Critical Care medicine leadership curriculum and the pediatric fellows educational and QI curriculum.

Debra Lotstein, MD, MPH
Medical Director, Division Chief

Ilanit Brook, MD, MSHS
Fellowship Director, Attending Physician

Gitanjli “Tanya” Arora, MD
Attending Physician

Christopher Adrian, MD
Attending Physician

Heather Bemis, PhD
Psychologist

Mallory Fossa, MSN, PNP
Nurse Practitioner

Rebecca Oberfield, DNP
Nurse Practitioner

Rachel Rusch, LCSW
Social Worker, Support and Bereavement Coordinator

Jennifer Greenman, LCSW
Social Worker, Support and Bereavement Counselor

Menchie Caliboso, MA
Research Specialist

• Children’s Hospital Los Angeles - Division of Palliative Care
• Providence Trinity Kids Care and Trinity Home Hospice
• All Saint’s Sub-acute Facility
• Kaiser Permanente Southern California Palliative Medicine Service

• Career Development Mentor
• Research/ Quality Improvement Mentorship

2017-2018 Ann Wilbanks MD- Attending Physician Pediatric Pain, Palliative, and Integrative Medicine Team Children’s Minnesota Hospital, Minneapolis Minnesota

2018-2019 Sarah Dabagh MD- Pediatric Palliative Care Director, Miller Children’s and Woman’s Hospital Long Beach, California

• 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: $71,550 minimum
  Post Graduate Year 5: $73,150 minimum
  Post Graduate Year 6: $74,900 minimum
  Post Graduate Year 7+: Compensation will be at the discretion of each division
• Benefits Include: Health and dental insurance, 14 days paid vacation+ 6 protected sick days, yearly educational stipend, monthly meal stipend, and 401(k) matching up to 3%