Hospice and Palliative Medicine Fellowship
The Accreditation Council for Graduate Medical Education (ACGME) accredited Hospice and Palliative Medicine Fellowship at Atrium Health is a collaboration between the one-of-a-kind Department of Supportive Oncology (DSO) at Levine Cancer Institute (LCI) and Carolinas Palliative Care and Hospice Group (CPCHG).
Fellows will train to become next generation physician leaders delivering compassionate and clinically excellent care in Hospice and Palliative Medicine. The comprehensive post-graduate year offers the advantage of a guided learning experience and direct patient care.
Fellows can choose between a one-year ACGME accredited clinical Hospice and Palliative Medicine (HPM) Fellowship track OR a two-year academic fellowship track in HPM (year 1: ACGME) and Supportive Oncology (year 2: non-accredited).
The Department of Supportive Oncology has four established fellowship tracks to provide physicians and clinicians the skill sets and techniques needed to deliver patient-centered care: Hospice and Palliative Medicine (in partnership with Carolinas Palliative Care and Hospice Group), Supportive Oncology, Psycho-Oncology (clinical psychology), and Cancer Rehabilitation (in partnership with Atrium Health Carolinas Rehabilitation Charlotte).
For more information on any of the fellowships, please contact Lisette.Clementecline@AtriumHealth.org.
Where You Will Train
Carolinas Medical Center
CMC is the flagship hospital of Atrium Health and the largest hospital in the region. CMC serves as the region’s only Level 1 trauma center and is an approved transplant center for heart, kidney, pancreas and liver. With Wake Forest University School of Medicine serving as the academic core of the Atrium Health enterprise, CMC also serves as one of North Carolina’s 5 Academic Medical Center Teaching Hospitals. The Wake Forest School of Medicine in Charlotte is slated to open in 2024.
Center for Supportive Oncology, Levine Cancer Institute, Building 2
The Department of Supportive Oncology is chaired by Dr. Declan Walsh, Hemby Family Endowed Chair, and palliative medicine pioneer and visionary. DSO includes the Sections of: Oncology Palliative Medicine, Integrative Oncology, Cancer Rehabilitation, Oncology Nutrition, Psycho-Oncology, Cancer Navigation, Cancer Survivorship, Senior Oncology, Research and Education.
The DSO research strategy centers around four thematic areas: Cancer Pain and Opioids, Malnutrition and Inflammation, Psycho-Oncology, and Cancer Related Fatigue. Each area has a research taskforce, which is comprised of subject matter experts from the Department, Levine Cancer Institute, Atrium Health, and strategic partners within the community. The purpose of each taskforce is to establish partnerships and develop research projects.
The 7th floor of LCI Building 2 is devoted entirely to supportive oncology services and is the largest square footage (33,000) devoted to supportive oncology in the world. In addition to a 4-bay palliative medicine infusion suite, the space houses a rehabilitation gym, an acupuncture suite, and spaces for massage therapy and healing touch.
Features of the floor include a dedicated fellow office and a suite of conference rooms that overlook the Charlotte skyline; these rooms host administrative meetings, support groups, classes, and other activities. There are nourishment stations with beverages and snacks positioned throughout the suite for use by patients, visitors, and staff.
Rotations
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The inpatient team has 10,000 new consults per year across 9 Atrium Health hospitals, and over 2,000 at the main hospital, seeing oncology, non-oncology, ICU (CCU, NSICU, Trauma, MICU) and non-ICU patients.
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LCI provides cutting-edge cancer care in a community, academic hybrid setting with 25+ locations throughout the region with strong referral streams in a large tertiary referral center and over 17,000 new patients per year. LCI’s academic and research headquarters and DSO reside on the CMC campus. The outpatient palliative medicine clinic has 5 regional locations with over 700 consults per year.
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Multispecialty Palliative Medicine Clinic
The Multispecialty Palliative Medicine Clinic focuses on providing interdisciplinary care to patients with serious medical and oncological illnesses. Caring for patients with heart, liver, and kidney disease, including peri-(solid organ) transplant and peri-LVAD care, is the clinic’s primary focus.
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LCH is the most comprehensive children’s hospital between Atlanta and Washington, DC and treats more pediatric patients per day that any other North Carolina hospital. LCH is the region’s only pediatric transplant program for heart, kidney, liver, and blood and marrow transplant, and the only pediatric CICU dedicated to caring for children with heart conditions, with the region’s only ECMO capabilities. LCH also features the region’s first 24/7 emergency room for children, staffed by physicians trained in pediatric emergency medicine.
The PACT (Pediatric Advanced Care Team) at LCH is a dynamic, multidisciplinary inpatient consult service, providing symptom management, family support, advance care planning and bereavement services to seriously ill children and their families. The team consists of a physician, advance practice provider, social worker and registered nurse coordinator.
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Hospice of Union and Anson Counties, led by a medical director, provides care at home and at the McWhorter Inpatient Unit, which has a total of 12 beds with 6 for general inpatient.
The team had 4 Center to Advance Palliative Care (CAPC) abstract recognitions in 2021. The hospice service line and community-based palliative care is led by Medical Director, Bridget Earle, MD, HMDC, FAAHPM, who was accepted to the American Hospital Association Women’s Equity and Leadership (WEL) Scholars Program for 2021-2022.
In response to the COVID-19 pandemic, the palliative care and hospice team converted to a virtual platform to perform/maintain palliative and hospice visits. The team initiated automatic palliative consultations and weekly palliative coverage for COVID-19 designated Skilled Nursing Facility (SNF).
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Hospice & Palliative Care of Cabarrus County, also led by a medical director, provides care at home and at Tucker House, which has a total of 24 beds with 14 for general inpatient. 3 MD and 6 APP hospice practitioners serve a combined daily census of approximately 300 patients.
Care transformation projects initiated a high acuity workgroup and created new policies for palliative sedation, non-invasive ventilation and LVAD removal. An acuity triage document was created for SNF palliative consultations, and a new and improved hospice heart failure program launched.
New initiatives to revise IV Lasix protocol align with Atrium Health Sanger Heart and Vascular Institute to decrease heart failure length of stay. The Charleston Co-morbidity Index (CCI) increased palliative and hospice consultations and follow-ups were initiated for post-acute palliative care SNF consults.
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Part of Atrium Health, Sardis Oaks nursing home provides skilled nursing and rehabilitative services for short-term, long-term and end-of-life care.
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Sharon Towers is a continuing care retirement community offering independent living, assisted living and skilled nursing care for older adults. It was founded in the late 1960s by Presbyterian leaders in Charlotte. The not-for-profit community is home to over 300 residents on a 28-acre campus in the SouthPark area of Charlotte. The geriatric medicine fellow provides primary geriatric care in an outpatient clinic on the Sharon Towers campus in addition to providing medical services to patients in assisted living and skilled nursing facilities.
Recognitions
The European Society for Medical Oncology (ESMO) honored Levine Cancer Institute as North Carolina’s only Designated Center of Integrated Oncology and Palliative Care. ESMO only bestows this honor on “cancer centers which provide comprehensive services in supportive and palliative care as part of their routine care” and those who achieve a “high standard of integration” in doing so. Care is a team effort at LCI, whose supportive oncology team works in concert with the medical oncology team to provide the highest level of care for all patients. LCI joins only four other cancer centers in the United States as well as over 200 sites worldwide to be so recognized.
The Multinational Association of Supportive Care in Cancer (MASCC) recognized Levine Cancer Institute’s Department of Supportive Oncology as one of only two Designated Center of Excellence in Supportive Care in Cancer. The certification program recognizes oncology centers that demonstrate best practices in supportive cancer care. MASCC’s certification program aims both to educate and to encourage a supportive care focus among oncology healthcare professionals.
The Commission on Accredited Rehabilitation Facilities (CARF) recognized Atrium Health, Levine Cancer Institute’s Cancer Rehabilitation program as the world’s first to earn accreditation in cancer rehabilitation.
Carolinas Medical Center has been named the Best Hospital in the Charlotte region by U.S. News & World Report for 5 years in a row.
Levine Cancer Institute is the only cancer center in the region to be nationally ranked by U.S. News and World Report.
Levine Children’s Hospital has been named Best Children’s Hospital for many years and is nationally ranked in 8 specialties.
Levine Cancer Institute is the first cancer network in the world to earn the top distinction in patient-centered care by excelling across more than 50 criteria of patient-centered care to be designated as a Planetree Patient-Centered Organization.
Atrium Health Hospice received four Center to Advance Palliative Care (CAPC) abstract recognitions 2020-2021.
Atrium Health has received the American Hospital Association’s Quest for Quality Prize and was the recipient of the 2020 Centers for Medicare & Medicaid Services Health Equity Award for its efforts to reduce racial and ethnic disparities in care.
Core Faculty
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Armida Parala-Metz, MD, FACP, FAAHPMProgram Director; Medical Director, Rapid Access Service for Symptom Management; Section Chief – Senior Oncology, Department of Supportive Oncology; Assistant Professor of Medicine
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Alexandra Walczyszyn, MDAgency Medical Director – Hospice of Union County; Hospice of Anson County; Carolinas Palliative Care & Hospice Group
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Boris Krivitsky, DOMedical Director, Multispecialty Palliative Medicine Clinic – Carolinas Palliative Care & Hospice Group
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Susan LeGrand, MD, FACP, FAAHPM
Physician – Department of Supportive Oncology Levine Cancer Institute
Faculty
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Lisette Clemente-ClineProgram Coordinator, Hospice & Palliative Medicine and Supportive Oncology Fellowships, Department of Supportive Oncology
Curriculum
The curriculum allows fellows to cultivate broad knowledge of the interdisciplinary approach to Hospice and Palliative Medicine. Fellows will work collaboratively with advance practice providers, nurses, medical assistants, social workers, chaplains, and other health professionals.
Although the one-year fellowship is clinically focused, fellows will spend time engaged in clinical research or quality-improvement projects related to palliative medicine and supportive oncology.
Fellows will have half-day longitudinal continuity clinic experience in the outpatient palliative medicine clinic in the Department of Supportive Oncology.
Elective rotations allow fellows to enhance clinical skills in a specialty area or in a specific clinical setting.
Fellows participate in interdisciplinary team meetings, case conferences, and journal clubs for critical review of important research influencing clinical HPM practice.
Formal didactic sessions complement clinical training experiences such as, a Serious Illness Conversation workshop. A weekly core lecture series covers important topics in Hospice and Palliative Medicine and prepares fellows for certification examination in the specialty.
Weekly departmental and monthly institutional Grand Rounds cover current information and new developments, as well as best clinical practices from the presenter’s area of expertise, presented as literature reviews, newly published journal articles and in-depth clinical case studies.
Weekly Supportive Oncology Research Meetings serve to collaborate on and review research concepts and protocol development, and allow for multidisciplinary feedback on abstract, poster and manuscript submissions. Fellows will collaborate on research and quality improvement projects and may present abstracts at national and international conferences and publish in peer-reviewed journals.
Resiliency training for fellows is led by a Department of Supportive Oncology Psychologist (PhD) and aims to reduce burnout and increase physician wellness through an ASCO developed skills-based program.
Application Criteria
We welcome applications from physicians who have completed an ACGME accredited residency program in a sponsoring specialty for Hospice and Palliative Medicine: Internal Medicine, Family Medicine, Pediatrics, Anesthesiology, Emergency Medicine, Neurology, Psychiatry, Radiation Oncology, Surgery, Obstetrics and Gynecology, or Physical Medicine and Rehabilitation. Applicants should be board-certified or board-eligible with intention to complete board certification, in their primary specialty.
Applications are accepted from participants in the National Resident Matching Program (NRMP) through the Electronic Residency Application Service (ERAS).
We will begin reviewing applications upon submission. Applications are preferred by September 1 each year. The interview season runs from August – October.
Interviews will be conducted virtually for the 2023-2024 academic year.
- MyERAS Application
- Curriculum Vitae
- USMLE or COMLEX scores
- Personal Statement outlining reason for pursuing a career in palliative medicine, experiences with palliative care, and career goals
- Three (3) letters of recommendation, including one from the Program Director or Department Chair. Letters should indicate that the applicant is personally known to the letter writer, and include an assessment of medical knowledge, clinical skills, and character.
Helpful Information
For the 2022-2023 academic year, salaries for trainees are as follows:
- PGY-4 $68,800
- PGY-5 $71,800
- PGY-6 $74,500
- PGY-7 $77,200
- PGY-8 $80,500
- 15 weekdays of paid vacation
- 5 additional days of vacation to be taken during PGY-3 OR subsequent year (Not each additional year). Vacation days are approved by the program director and may not be taken during certain blocks.
- $1900 and up to 5 days CME allowance
- Two Medical plan options
- Dental and Vision insurance
- Medical, Family & Parental Leave
- Professional Liability Insurance
- Short and Long-term Disability Insurance
- 401k with up to 4% matching contribution and performance-based contribution
- 3 lab coats with laundry service provided. One additional coat for subsequent academic year.
- Access to gym and physician lounge on CMC-Main campus
- Free parking
More information about Atrium Health salary and benefits are available in the 2022-23 Summary of Benefits for Residents and Fellows.
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Arts & Entertainment
- Concert Venues
- Charlotte Opera
- Charlotte Symphony
- Charlotte Ballet
- Blumenthal Performing Arts Center's Traveling Broadway series
- Levine Center for the Arts
- The Mint Museum
- Harvey B. Gant Center for African-American Arts + Culture
- Knight Theater
- Bechtler Museum of Modern Art
- Discovery Place
- Paramount's Carowinds Theme Park
- NASCAR Hall of Fame
- Billy Graham Library
- Carolinas Aviation Museum
- Daniel Stowe Botanical Garden
- U.S. National Whitewater Center
Sporting Events
- NBA - Charlotte Hornets
- NFL - Carolina Panthers
- NASCAR - Home of Charlotte Motor Speedway
- PGA - Wells Fargo Golf Championship
- Minor League Hockey - Charlotte Checkers
- Minor League Baseball - Charlotte Knights
- NCAA Sports - University of North Carolina at Charlotte
- U.S. National Whitewater Center
Weather
- January: average low 30º - average high 49º
- June: average low 70º - average high 89º
- Sunny days: 214/year
- Average precipitation: 43.1 in.
- Average snowfall: 5-6 in.
Recreation
- U.S. National Whitewater Center
- Two large lakes within half an hour of Charlotte
- Just over three hours to the Carolina beaches
- Two hours to the North Carolina mountains
- Many beautiful golf courses in town
- Many parks all around town
- Active community
- YMCA network with over 10 locations in the Charlotte area, including one less than two miles from Carolinas Medical Center
- Year-round festivals and events
Restaurants
We have it all! A great variety less than one mile from Carolina Medical Center. Choices include Southern cooking, sushi, Italian, Mexican, seafood and more.
Where do I live?
- Most residents live within a 10-mile radius
- Average commute is under 20 minutes
- Safe and affordable housing
- Small town neighborhood feel despite being in a "big city"
- Excellent public school system
Local Colleges/Universities
- UNC Charlotte
- Queens University of Charlotte
- Davidson College
- Winthrop University
- Belmont Abbey College
- Johnson C. Smith University
- Johnson & Wales Culinary Institute
Regional Universities
(Near Charlotte)
- Duke University
- UNC Chapel Hill
- NC State University
- Wake Forest University
- Clemson University
- University of South Carolina
More About Charlotte
For more information about Charlotte, visit:
- www.charlottesgotalot.com
- www.charlottechamber.com
- www.charlotteobserver.com
- www.charlotteparent.com
- www.charlottesports.org
Quick Facts
- Population 859,035
- Seventeenth largest city in United States
- Second-largest banking center in the nation
- Encompasses 268 square miles
- Four hours from the Atlantic Ocean
- Two hours from the Appalachian Mountains