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, Registered nurse, social workers, and a psychologist. We see on average 500 new consults annually across all pediatric ages. Reasons for consult range from symptom management to coping with a new diagnosis to exploring treatment goals in advanced illness. Fellows also spend 3 weeks training on the inpatient palliative consultation service at Kaiser Los Angeles Medical Center where they see mainly adults.

Fellows spend 10 weeks on the home visit rotation with Trinity Kids care and Trinity home hospice. The fellow spends 8 weeks with the home pediatric palliative/hospice service and 2 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, 1 week at a Skilled Nursing Facility that cares for adults and 1 week where children are care for. 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 serve in a weekly 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.

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 pain clinic.

Fellows have 1 month elective opportunity, which may include research or other clinical or educational opportunities.

Fellows participate in the Anesthesia/Critical Care medicine Leadership Curriculum.

Debra Lotstein MD, MPH: Medical Director, Fellowship Director

Ilanit Brook MD, MSHS: Associate Fellowship Director, Attending Physician

Gitanjli “Tanya” Arora, MD: Attending Physician

Linda Radbill, PhD: Psychologist

Bethaney Kaye, FNP, DNP: Nurse Practitioner

Mallory Fossa, PNP: Nurse Practitioner

Helene Morgan, MSW: Social Worker, Support and Bereavement Coordinator

Danielle Jonas, MSW: Social Worker, Support and Bereavement Counselor

• 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

• Salary:
  - PGY4: $63,344 minimum
  - PGY5: $65,018 minimum
  - PGY6: $67,225 minimum
  - PGY7: $69,506 minimum
  - PGY8+:Compensation will be at the discretion of each division
• Health, dental, basic life, and disability insurance available
• Malpractice insurance provided
• 14 days paid vacation + 6 personal days per year
• Educational stipend
• Funding to attend one academic conference
• Reduced rate for covered parking
• Office space, computer, pager
• Textbooks and other resources available