New Palliative Medicine Fellowship program for Pacific Northwest physicians

While end-of-life care issues have come front and center in the current health care reform debate, physicians in the Pacific Northwest can now get more intensive training and new board certification in palliative medicine and hospice care.

The new Palliative Medicine Fellowship program, the first of its kind in the state of Washington, is a cooperative effort between Providence Hospice of Seattle and the University of Washington School of Medicine. Providence is providing funding to help launch and sustain the UW program. The first physician began training in the program in July 2009. Four others will begin the intensive year-long program in July 2010.

Hospice and Palliative Medicine is a relatively new medical subspecialty to receive formal accreditation status. The American Board of Medical Specialties (ABMS) and the Accreditation Council for Graduate Medical Education (ACGME) in October 2006 announced formal endorsement of hospice and palliative medicine as a medical subspecialty. The ABMS offered the first certification exam in November of last year. In the past, certification was possible through the American Board of Hospice and Palliative Medicine, but making palliative care an official subspecialty takes it to a much higher level, said Dr. Wayne McCormick, medical director of Providence Hospice of Seattle and Program Director of the UW Palliative Medicine Fellowship program.

"This will definitely help grow the area of palliative care in this region and throughout the United States," McCormick said. "It's a giant step forward in helping patients at the end of their lives - and their families too."

"Palliative care recognizes the emotional side of the human experience," Dr. McCormick said. "It recognizes that everyone dies and that the medical community and the patients served should embrace that and find a way to make it - at least - a comfortable passage and - at best - to celebrate it as the human experience. This is a shift from where American medicine is now. This helps physicians address not only the physical pain at the end of life, but the emotional suffering as well."

Dr. McCormick noted that while only a minority of individuals need major pain medications at the end of life, many more need significant emotional support. Physicians and hospice teams treat all who are present around a dying person as one entity. The team helps support families of the dying person through their grief. "The dying person may have tremendous unresolved spiritual or emotional issues with their families," Dr. McCormick said. "That's part of the training for the fellows."

Those enrolled in the new Palliative Medicine Fellowship program must have completed their residency in a medical specialty. Palliative Medicine Fellows can only come from one of the following medical specialties: anesthesiology, emergency medicine, family medicine, internal medicine, obstetrics and gynecology, pediatrics, physical medicine and rehabilitation, psychiatry and neurology, surgery, and radiology. Fellows will train at local hospitals and Providence facilities. Each trainee will work for several months in a hospital setting, spend 15 percent of the time in a hospice setting, spend one month in a long-term care facility such as a nursing home, and will see palliative medicine patients in a clinic for six months.