Authors:
Amos Bailey, MD – Clinical Professor, Internal Medicine
Melissa C. Palmer, JD LCSW ACHP-SW APHSW-C – Director, MS in Palliative Care
Maurice “Scotty” Scott, MD – Co-Director, Community Hospice & Palliative Medicine Fellowship, University of Colorado
Katie Morrison, MD – Co-Director, Community Hospice & Palliative Medicine Fellowship, University of Colorado
David Nowels, MD MPH – Associate Program Director, University of Colorado Hospice & Palliative Medicine Fellowship
- What inspired the creation of this mid-career fellowship program?
In the middle of their careers, some physicians develop an interest in HPM. However, for many of them, it may be impractical to leave their community practices to attend a traditional HPM fellowship. The CHPM Fellowship, in conjunction with the on-line asynchronous interdisciplinary MS in Palliative Care (MSPC), provides an opportunity for physicians to gain high-quality HPM education and board eligibility. - How does this program address the current projected workforce shortage in HPM?
Practicing physicians interested in HPM learn practical, evidence-based, patient-centered palliative care skills from the MSPC. The CHPM fellowship then allows them to partner with medical organizations in their community to provide robust clinical experiences. Thus, palliative care can be immediately provided to underserved communities throughout the nation. For example, one current fellow is a physician for the Indian Health Service on the Katmai Peninsula in Alaska. Another is a bilingual/bicultural physician working in the Rio Grande Valley in Texas. The educational rigor of the MSPC and CHPM meets ACGME accreditation. - What makes this fellowship unique compared to traditional HPM training paths?
Unlike traditional fellows, CHPM fellows participate part-time over a span of 3-4 years. Initially, prospective fellows complete the online MSPC at the University of Colorado. The MSPC uplifts the palliative care interdisciplinary philosophy with leadership, faculty and students from a wide range of professional fields. After successful completion of the first year of the MSPC, they apply to the CHPM program where they develop their palliative clinical expertise by seeing eligible patients in their local communities to develop a diverse clinical portfolio. CHPM faculty assess and provide feedback using clinical documentation of fellows’ patient encounters and through virtual, online learning activities. - Why focus on mid-career professionals instead of early-career or residency-level trainees?
CHPM focuses on mid-career physicians because they are a potentially untapped workforce that can help meet the need for palliative care services across the nation. The palliative care community needs to provide multiple pathways in order to increase the number of fellows. The University of Colorado CHPM fellowship offers an alternative option to the traditional HPM fellowship while retaining academic rigor. - How is the curriculum tailored for physicians who are already practicing?
Both the MSPC and CHPM apply best practices of online- and adult-learning theory to effectively and efficiently deliver education and training. Competency-based assessments support feedback and individualized learning plans. As a result, practicing physicians can maintain their part-time positions while developing specialty level expertise in HPM. To date, 32 fellows from 8 medical specialties living in 18 states have matriculated. 18 of the 32 have graduated and 14 are currently enrolled. Thirteen fellows have taken and passed their initial HPM board certification exam; thus, the program has a 100% HPM Board pass rate. - How do you envision graduates of this program impacting community-based hospice and palliative care?
After five years since inception, the CHPM was approved by the ACGME to be a permanent pathway within the University of Colorado traditional fellowship. Currently CHPM is approved for 12 part-time fellows yearly. CHPM is supporting physicians both from diverse primary specialty backgrounds and geographical locations. They are then able to bring these skills into their practices, specialties and communities.