Clinical Rotations

Fellows spend three months of the fellowship year on inpatient consultation services at UCI Health's Douglas Hospital. The 459-bed acute care hospital provides tertiary and quaternary care. Ambulatory and specialty medical clinics as well as behavioral health and rehabilitation services are also available at the medical center in Orange. Our inpatient consult service sees over 1,200 patients a year.

Fellows take part in daily interdisciplinary rounds with the palliative care team, which includes attendings, residents, medical students, advanced practice nurses, social workers, a pharmacist, medical assistants and a chaplain. Fellows are expected to collaborate with the team to identify and address patients’ physical, medical, emotional, social, familial and spiritual needs. They are responsible for managing patients in an interdisciplinary clinic setting, functioning much like attending physicians. They are also responsible for the initial patient presentation and overseeing the resident and medical student presentations. Fellows also have continuity clinic at UCI Health on either Mondays or Fridays.

Fellows spend two weeks focusing specifically on the care of seriously ill pediatric patients at Miller Children’s and Women's Hospital in Long Beach. While on this rotation, fellows lead scheduled, formal IDT meetings with nurse practitioners, physicians, nurses, social workers, case managers and chaplains.

Fellows are responsible for coordinating care between specialists, primary care pediatricians and the interdisciplinary team to provide family-centered care for these children. The fellows follow their patients into home hospice or home palliative care.

Fellows spend approximately one month on the inpatient palliative care consultation service at Hoag Memorial Hospital Presbyterian, a large community medical center in Newport Beach.

While on this rotation, they participate in a formal IDT daily meeting, which includes physicians, an advanced practice nurse, social workers and a chaplain. Fellows are expected to coordinate intensive whole patient care, family support and teamwork, in partnership with the referring teams. The objective is to meet the needs of patients and their families. The focus of the IDT at Hoag is communication.

Fellows spend at least two months at the VA Long Beach Healthcare System. Fellows are expected to lead the weekly meeting of the interdisciplinary team, which includes a physician, a nurse practitioner, a social worker, nurses, a psychologist, a chaplain and a recreation therapist. They are expected to take on the role of attending physician during this meeting and help coordinate an interdisciplinary care plan for inpatient unit patients.

During this rotation, fellows care for patients in the hospital's inpatient hospice unit. They also participate in new inpatient consultations to determine whether patients are appropriately assigned to the hospice unit.

Fellows spend at least 10 weeks seeing hospice patients through the hospital agency VITAS Healthcare® in Orange County. Fellows participate in two weekly hospice interdisciplinary team (IDT) meetings.

During the first week of rotation, fellows shadow the team physician. In subsequent weeks, fellows take on increasing responsibility for creating comprehensive, interdisciplinary hospice care plans for the patients. About half the patients are in long-term care facilities. Fellows work under the supervision of the team physician and in conjunction with a team of nurse case managers, licensed vocational nurses, chaplain/bereavement counselors, social workers and home health aides. The goal is for fellows to take on the team physician role by the rotation's end.

Fellows spend one month on their elective rotation. Previous fellows have selected the following: research, interventional-chronic-ambulatory pain, ethics, integrative medicine and inpatient hospice.

Other examples of opportunities include: neurocritical care, rehabilitation, cardiovascular ICU service, HIV clinic and home dialysis. We are open and flexible to meet the requests and needs of fellows.

Vacations/Time Off

Fellows have four weeks of vacation and have all major holidays off.

Call

Fellows work 12 weekends a year.

View a sample schedule.