Clinical Rotations | Emory School of Medicine

The clinical rotations for our Standard Track fellows provide exposure to a wide array of patients by training at multiple sites and in various settings. In our inpatient rotations, fellows have the opportunity to see new palliative care consultations in the inpatient setting and, when appropriate, follow these patients as they are admitted to inpatient hospice at the same facility.

As we hope to see many patients far upstream from the time they are eligible for hospice, many new palliative care consultations will be discharged with plans for outpatient palliative care follow-up. Other patients will come to our care as new inpatient hospice referrals, and in these cases, fellows will complete hospice admission assessments, plans, and orders.

Fellows will also engage in in-home hospice care, long-term care, pediatric palliative care, interventional pain, outpatient management, and ambulatory clinic settings.

Grady Memorial Hospital

6 weeks including 2 weeks of inpatient hospice
2 weekends including consultation and hospice care

Palliative care consults throughout the hospital (including trauma and neuro ICUs).

Hospice care either "in place" (in the patient's previous location, e.g. ICU, step-down unit) or on one of two floors with a "focused bed model" (medical-surgical wards where the nursing staff has been trained to care for patients at the end of life.

Emory University Hospital

6 weeks including 2 weeks of inpatient hospice
8 weekends with a focus in the hospice unit

Palliative care consults throughout the hospital (including oncology and bone marrow transplant services, advanced heart failure service for VAD and pre-transplant preparedness consults, and multiple ICUs).

Hospice Care in a 6-bed dedicated hospice unit.

Emory University Hospital Midtown

6 weeks including 2 weeks of inpatient hospice

Palliative care consults throughout the hospital (including head & neck cancer, general oncology, and multiple ICUs).

Hospice Care in a 3-bed dedicated hospice unit.

Atlanta VA Medical Center

13 weeks of inpatient palliative care consultation

Fellows perform palliative care consultation throughout the hospital for patients both new to our service and those actively followed by our extensive outpatient practice who are admitted to the hospital. We have a 12-bed inpatient palliative care unit on which any patient appropriate for palliative care consultation can receive care. This is an open unit in which patients' primary house staff teams or hospitalists continue to serve as the primary team for patients and the palliative care team provides close collaborative consultation and multidisciplinary care for patients and families.

Pediatric Palliative Care

3 weeks

At Children's Healthcare of Atlanta, fellows have the opportunity to join the Pediatric Advanced Care Team (PACT) where they see team-based palliative care in action every day.

Palliative Care Continuity Clinic

One half-day per week

Fellows have the opportunity to follow a panel of patients throughout the year in their continuity clinic. Each fellow will be assigned to have a clinic at one of the following outpatient palliative care sites: Atlanta VA Medical Center, Grady Healthcare, Emory Supportive Care Clinic. As a Palliative Care Center, we have been successful in garnering upstream palliative care referrals for patients with a variety of primary diagnoses and thus often follow patients in outpatient palliative care clinics for years while they are living with their serious illness.

Therefore, our clinic practices focus on identifying sources of suffering and working to improve the quality of life. Depending on the patient's needs, clinic interventions may include pain management, non-pain symptom management, psychosocial support for patients and their caregivers, shared decision-making, discussion of advance care planning and goals of care, and discussion of additional home services including hospice when appropriate.

Harbor Grace Hospice

4 weeks

Fellows complete home visits along with members of the hospice interdisciplinary team including nurses, social workers, and chaplains. In addition, fellows receive one-on-one education and supervision by the Hospice Medical Director such that they can learn the requirements and intricacies of this complex role.

Long-Term Care

4 weeks

Fellows learn about the principles and practices of geriatric medicine in a long-term care setting by caring for a panel of residents at Budd Terrace at Wesley Woods.

Interventional Pain

Half days for 3 weeks

In partnership with our anesthesia colleagues trained in pain management at the Atlanta VA Anesthesia Pain Service, fellows participate in the outpatient clinic and inpatient consultations and have the opportunity to observe procedures

Outpatient Management

Half days for 3 weeks

During this rotation, which is paired with the Interventional Pain rotation, fellows learn about the intricacies of management of the VA Palliative Care Team's large outpatient practice.

Elective Rotations

4 weeks at various locations

Each fellow will have the opportunity to complete 4 weeks of elective during the year. Fellows can choose to complete one 4-week elective or two 2-week electives. The location and clinical focus of the elective will be determined by the fellow in consultation with his or her mentor and fellowship directors and will be based on the fellow's identified interests and learning needs.