Pediatric Palliative Track

Pediatric Track in Hospice and Palliative Medicine Fellowship

Fellowship

The pediatric track in the Hospice and Palliative Medicine fellowship at UT Health San Antonio combines robust pediatric experiences with the adult-focused fellowship activities. The pediatric training emphasizes pediatric complex care with a focus on children with medical fragility.

Pediatric Track in Hospice and Palliative Medicine Fellowship

UT Health San Antonio has a well-developed three-pronged pediatric palliative program including fully integrated outpatient, inpatient, and hospice services

The outpatient complex care program has a dual purpose: primary care for pediatric patients with medical fragility as well as outpatient palliative care. Fellows will have longitudinal pediatric clinic experiences and learn to develop care plans that address condition-specific, primary care needs in the context of the whole family and quality of life.

  • Fellows will split their inpatient clinical time between the pediatric and adult palliative services. Fellows will graduate with the ability to competently address the needs of an aging medically complex pediatric population. Pediatric fellows will have the opportunity to master the adult competencies addressed on the hospice and palliative medicine board exam.

Graduating fellows will be able to comfortably practice both adult and pediatric palliative care, which is often delivered by one physician at smaller hospice agencies and rural community hospitals.

The pediatric program also includes a rapidly growing Perinatal Palliative program which follows mothers from the time of diagnosis of severe anomalies with their baby through the pregnancy and delivery. If the infant is born alive the Perinatal Palliative care team will follow through the hospitalization and if discharged either on the hospice or clinic service.

Fellows will also rotate with a community hospice agency, working with an interdisciplinary team to develop skills to care for both pediatric and adult hospice patients.

Palliative medicine is an interdisciplinary field and the hospice and palliative fellowship at UT Health San Antonio is an interdisciplinary training program. Fellows will train alongside other non-physician fellows from other disciplines including social work, psychology, chaplaincy, pharmacy,  and nursing. Fellows from the various disciplines actively work together on cases and learn to practice with an interdisciplinary approach.

Research

The program is research-oriented. Each fellow will be paired with a faculty mentor and will be expected to develop at least one scholarly project and submit an abstract to the Annual Assembly of the American Academy of Hospice and Palliative Medicine and other applicable conferences. The curriculum includes 4 weeks of dedicated research time, which includes a 2-week formal research-training course in the fall. Ongoing research is conducted throughout the fellowship and additional elective research rotations are available. All fellows also participate in a quality improvement project.

Curriculum and Schedule

Curriculum

The combined program has twice weekly lectures aimed at both adult and pediatric fellows from all disciplines. A longitudinal ethics course is built into the program curriculum.

At the start of each academic year, all fellows participate in a hospice and palliative medicine focused Observed Structured Clinical Examination (OSCE).

Schedule

Below is a sample schedule of rotations. Clinic time is divided between adult palliative experiences and pediatric palliative experiences. Adult focused rotations will be scheduled in the fall with the intent that the last several months of fellowship are completely pediatric focused as fellows prepare for practice after fellowship.

Pediatric fellows will have continuity clinic one afternoon every week at the complex care clinic at the RBG facility. Fellows will be responsible for managing their own panel of patients.

Example Schedule

Block 1Pediatric Inpatient Palliative Service (UH)
Block 2Adult Inpatient Hospice Service (VA)
Block 3Research Course/Independent Research
Block 4 Adult Inpatient Palliative Service (UH)/ Pediatric Inpatient Palliative Service (UH)
Block 5Adult Inpatient Palliative Service (VA)
Block 6Adult Inpatient Palliative Service (UH)/ Pediatric Comprehensive Care Clinic
Block 7Adult Inpatient Palliative Service (VA)
Block 8Adult Inpatient Palliative Service (UH)/ Pediatric Inpatient Palliative Service (UH)
Block 9Pediatric Comprehensive Care Clinic
Block 10Community Hospice*
Block 11Pediatric Palliative Care Electives
Block 12Pediatric Inpatient Palliative Service (UH)

*NOTE: pediatric hospice is a longitudinal experience and occurs throughout the training year, fellows will have one month of adult community hospice time.

How to Apply:

Applicants must:

Have completed an ACGME-accredited Residency Program in Pediatrics prior to starting their Hospice & Palliative Medicine Fellowship
Be U.S. citizens, permanent residents of the U.S., or have a J-1 Visa
Applications for the UT Health San Antonio Hospice & Palliative Medicine Fellowship Program are submitted through the Electronic Residency Application Service (ERAS).
The following documentation is required with your ERAS application:

Current curriculum vitae
Personal statement
Three letters of recommendation—one must be from your residency program director
United States Medical Licensing Examination transcript
ECFMG certificate for graduates of international medical schools

ERAS applications are typically open for submission mid-July for a position starting on July 1st of the following year. Based on preliminary review of complete applications, interviews will be offered to selected applicants. Interview season typically runs from August to the beginning of November.

Our program participates in the National Residency Matching Program (NRMP), and all our fellowship positions are offered through this mechanism. NRMP # 1722540F0

Contact Us:

Name & TitleEmailPhoneName & TitleEmail
Jennifer Barker, DO
Program Director
HealyJ@uthscsa.edu210.617.5311Glen Medellin, MD
Pediatric Palliative Faculty Member
MedellinG@uthscsa.edu
Anjuli Vasquez, MD
Associate Program Director
VasquezAH@uthscsa.edu210.617.5311Hema Navaneethan, MD
Pediatric Palliative Faculty Member
Navaneethan@uthscsa.edu
Krysta Jo Sargent, MS
Program Coordinator
SargentK@uthscsa.edu210.617.5311Rachel Vandermeer, MD
Pediatric Palliative Faculty Member
Vandermeer@uthscsa.edu