Hospice and Palliative Medicine Fellowship Program
Mission Statement
Our mission is training fellows from diverse backgrounds to become outstanding Academic Palliative Medicine Physicians with the skills to conduct clinical research, teach the next generation of residents and fellows, and provide exemplary care to patients from all backgrounds, especially those from underserved and culturally diverse populations.
Overall Goals and Objectives
Our goal is to train outstanding Academic Palliative Medicine Physicians (clinicians, educators and researchers) and Hospice Medical Directors from diverse backgrounds to serve both adult and pediatric populations. Fellows will develop expertise in the management of all factors that contribute to the suffering of the patient and the patient's family across a full range of patients, families, and care settings. Graduates will be proficient in facilitation of medical decision-making and skilled at management of pain and non-pain physical symptoms associated with cancer and other serious and complex illnesses. Fellows will operate within mature interdisciplinary teams, and will be trained in the cultural, spiritual, religious, and existential aspects of palliative medicine, as well as the pragmatic fundamentals of operating within and across health delivery systems. We will be distinguished by diversity of training sites, stable interdisciplinary teams, formal, interactive training in communication skills and didactic presentations, and will provide particular emphasis on care of under served and culturally diverse populations.
- Application Process
Application Process
We welcome all applicants who have completed an Accreditation Council for Graduate Medical Education- or American Osteopathic Association-accredited residency program in Anesthesiology, Emergency Medicine, Family Medicine, Internal Medicine, Obstetrics and Gynecology, Pediatrics, Physical Medicine and Rehabilitation, Psychiatry, Neurology, Radiology, and Surgery.
International Applicants
Recognizing that some of our most talented applicants are not permanent residents, we are committed to recruiting qualified international trainees. UT Southwestern accepts permanent residents or J-1 ECFMG sponsored visas. Unfortunately, the medical school does not sponsor H-1B visas.
- Salaries and Benefits
Salaries and Benefits
Fellowship Year Program Year Salary Fellowship Year 1 PGY4 $72,486 - Adult and Pediatric Training Tracks
The Hospice and Palliative Medicine curriculum has been specifically designed to ensure that each fellow has the opportunity to achieve the knowledge, professional attitudes, and practical experience required of a physician caring for the seriously ill patient. Each fellow will participate in and will be closely supervised by trained faculty in the clinical activities described below. Each portion of the fellowship has clearly defined expectations, objectives, and goals. Both the preceptor and the fellow are expected to complete timely written evaluations.
Our fellowship follows a 4+1 model, in which the fellows spend four weeks intensively participating in a single, usually inpatient, experience, followed by one week of ambulatory experiences. The Palliative Care continuity clinic during the +1 week is a longitudinal rotation.
We offer both adult and pediatric tracks in our fellowship, see below for specific requirements of each.
Rotation Adult Track Pediatric Track Parkland 12 weeks 10 weeks Clements 8 weeks 4 weeks Children’s 2 weeks 8 weeks Hospice 10 weeks 10 weeks, pediatric focused Long term care 3 weeks 3 weeks, pediatric focused Elective 5 weeks 5 weeks, pediatric focused Clinic 9 weeks 9 weeks, pediatric focused The Hospice and Palliative Medicine Fellowship Program is pleased to provide a Pediatric Track for applicants interested in a career in Pediatric Hospice and Palliative Medicine. The Pediatric Track is a one-year fellowship accepting 1-2 applicants per year. This track combines rotations from the adult fellowship alongside pediatric rotations.
Applicants can expect 5-6 months of Pediatric-specific rotations. 2 months will be dedicated to the inpatient pediatric palliative medicine consult service at Children’s Medical Center. One month is dedicated to the palliative medicine service at Cook Children’s in Fort Worth. Additional pediatric rotations will include Pediatric Oncology, Pediatric Radiation Oncology, and long term care at a pediatric rehabilitation hospital. In addition to these pediatric-specific rotations, the fellowship’s longitudinal curriculum is tailored to meet the interests of Pediatric fellows.
The adult palliative medicine rotations will include service time with the Parkland Palliative Care consult service, the Clements University Hospital consult service, and the VA inpatient hospice unit. These rotations are quite busy, and the training in advanced pharmacologic symptom management and communication skills is robust. Previous pediatric fellows have found these adult rotations a vital part of their training with broad applications in their future careers as Pediatric Palliative Medicine providers.
Ambulatory Clinics
- Parkland Palliative Care Clinic
During their +1 week, when assigned to Parkland clinic, fellows attend Parkland Palliative Care clinic for 3-4 full-day sessions. Fellows see new patients, and are then able to schedule both their clinic patients and patients they have seen in the hospital to follow up with them in clinic. They also have the option, if their clinic patient transitions to hospice, to continue to follow those patients with one of our hospice medical directors. The Parkland site provides fellows with diverse ethnic and social experiences, and will provide 1-2 new patients per session and 2-3 follow up visits per session (depending on the volume), allowing the fellows to spend a minimum of a third of their ambulatory time providing continuity of care.
- Simmons Cancer Center
During their +1 week, when assigned to Simmons Cancer Center (SCC) clinic, fellows spend 2-3 full-day sessions seeing patients in this University-based Cancer Center of Excellence, where many patients are on clinical trials or receiving novel therapies. This provides familiarity with a different socioeconomic population but also with the side effects of an entirely different group of therapies.
- Additional Clinic Experiences
Fellows round out their +1 week with scheduled scholarly activity time and additional half-day experiences that help them meet their educational goals.
- Parkland Palliative Care Clinic
- Block Rotations
During the year fellows have specific block rotations that focus and concentrate on important areas of Hospice and Palliative Medicine, including inpatient consultation, pediatric palliative care, long-term care, and both inpatient and outpatient hospice. The rotations are monthly unless otherwise specified. Each rotation has an evaluation form to be completed at the end of service by both HPM fellows and faculty. These evaluations are used as part of an ongoing quality assurance program implemented to improve, modify and update the program.
- Children’s Medical Center Dallas
Pediatric track fellows spend 2 blocks at Children’s Medical Center Dallas and adult track fellows spend 1 block at Children’s Medical Center. Children’s Medical Center is a large, free-standing children’s hospital with 500 beds, a level I trauma center, level IV NICU, and an active PICU and CVICU. The palliative care team is well integrated into the hospital and, as such, fellows are exposed to pediatric patients with both life-limiting and multiple chronic conditions. Fellows gain expertise in the unique medical, social, and psychological aspects of caring for children living with serious illness and their families.
- Children’s Medical Center Inpatient Therapy Unit
Pediatric track fellows spend one month in the Integrated Therapy Unit, a long-term care facility for children with chronic illness. This unit provides a variety of services, including inpatient and outpatient therapy programs for children with neurologic illnesses, feeding programs for those with difficulty eating solid foods or swallowing, pulmonary services for children who need short-term tracheotomy/ventilator assistance and those who are vent-dependent and will return home, and rehabilitation services for children who have been involved in accidents or had a life-changing diagnosis. Formerly a stand-alone rehabilitation hospital, the program has now been integrated with Children's Medical Center Dallas. The rotation affords the opportunity to care for children with medical complexity in a multidisciplinary and longitudinal way.
- Clements University Hospital Consult Service
Clements University Hospital, UT Southwestern's flagship hospital, is a tertiary referral center where patients come for advanced therapies in cardiology, oncology, transplants, and more. Adult track fellows spend two months and pediatric track fellows spend one month working closely with faculty experienced in the care of patients pre- and post-transplant, receiving experimental therapies, on LVAD’s, ECMO, and more. They also hone formalized communication training skills with faculty specially trained in VitalTalk.
- Community Hospice
All fellows will work with various physicians and nurses during their 2-month community hospice block, attending hospice interdisciplinary team (IDT) meetings, and making periodic visits to both Faith and Vitas inpatient hospice units to participate in rounds there. This will be accomplished through partnerships with VNA, Faith, Community, and Vitas Hospices, who serve both pediatric and adult patients and families. The fellow will work closely with the IDT to facilitate patient and family/caregiver issues. Patients will be selected to ensure a diversity of medical and psychosocial backgrounds. The fellows will participate in a curriculum to ensure a full education regarding the regulatory and financial aspects of serving as a Hospice Medical Director and a physician in long-term care. The fellows will be able to tailor their experience to provide more of one setting, as well as longitudinal care for specific patients, if they wish to pursue hospice as a career goal.
- Long-term Care Adult Track
- Each fellow who is training to practice Hospice and Palliative Medicine in the adult setting will spend 3 weeks on long-term care in various settings: 1 week at the VA Community Living Center (CLC), 1 week at a nursing home, and 1 week on the Parkland inpatient rehabilitation unit.
- The VA Community Living Center (CLC) is a long-term care facility for veterans at the Dallas VA Medical Center. The CLC receives consults from both the surgical and medical teams at the VA hospital. During their time on the CLC, the fellows will learn which patients would benefit most by transfer to the Unit, as well as the continuum of care from acute to subacute care and then appropriate and timely disposition to permanent residence.
- The nursing home that fellows will rotate at is Windsor Gardens, a skilled nursing facility located in Lancaster, Texas. This week serves as a way for fellows to experience caring for a patient in post-acute care settings.
- The Parkland Inpatient Rehabilitation Unit is a 24-bed inpatient rehab unit located on the 17th floor of New Parkland Hospital. This unit provides inpatient rehabilitation care to meet the specialized need of patients aged 13 and up who are recovering from traumatic brain injuries, multiple trauma and other complex orthopedic and medical conditions, spinal cord injuries, arthritis, neurological disorders and other conditions that may leave the patients impaired. This unit also provides inpatient rehabilitation care to patients with burn injuries aged 10 and over. Patients admitted to the inpatient rehabilitation floor are treated by a team of professionals including rehabilitation physicians, nurses, physical therapists, occupational therapists, speech-language pathologists, recreational therapists, patient care technicians, psychologists, dietitians, orthotist/prosthetists, respiratory therapy, social workers and case managers.
- Parkland Palliative Care Consult Service
All fellow spend three months on the Parkland Palliative Care inpatient consult service. Parkland is the safety-net hospital for Dallas County and moved in 2015 to a new state-of-the-art facility. The service receives 30-40 new inpatient consults per week. Patients range in age from 18 to 105, and are living with diagnoses spanning the spectrum of advanced, progressive, life-threatening conditions (common cancers, common non-cancer diagnoses, chronic diseases, and emergencies). Most are indigent or working poor. On average, fellows see one new patient per day and 1-5 follow-up patients per day, but the volume is tailored to the fellow’s level of ability.
- VA Inpatient Hospice
All fellows spend two weeks working at the 19-bed Inpatient Hospice Unit at the Dallas VAMC. Patients are generally older, and represent a range of diagnoses. There are many palliative care patients with non-malignant disease. Fellows are first on call for consultations for hospice placement from the medical and surgical services at the VA hospital. Requests for consultation come from throughout the 289-bed acute care medical center, as well as the 90-bed skilled nursing facility and the 30-bed Spinal Cord Injury Center.
- Elective
Fellows have 1 block dedicated to clinical electives and are free to tailor elective time to their interests and needs.
Cook Children’s Hospital in Fort Worth
During their elective time, pediatric track fellows have the opportunity to rotate at Cook Children’s Hospital in Fort Worth. Fellows will be integrated into their interdisciplinary team of physicians, nurse practitioners, nurses, social workers, chaplains, and others to manage symptoms, provide emotional support, help families access community resources and guide transitions of care. The opportunity to see multiple versions of Pediatric Palliative Care teams can be vital for physicians pursuing a career in Pediatric Palliative Care.
- Children’s Medical Center Dallas
- Training Sites
Parkland Memorial Hospital
Parkland Health & Hospital System is our primary teaching hospital. Since the initial affiliation of the Medical School with Parkland in 1940s, the county hospital has provided an amazing spectrum of pathology in which to serve those in need and to learn. The new hospital, which was completed in 2015, has 862 beds and is equipped with the latest in medical technologies. Services include a Level I Trauma Center and the second-largest civilian burn center in the U.S.
Clements University Hospital
William P. Clements Jr. and Zale Lipshy University Hospitals make up our university practice, with the bulk of our clinical activity occurring in the former hospital. Clements was newly constructed in 2014 and carries 460 beds. It serves as a tertiary referral center for complex cases and is recognized as a leading center in North Texas for heart, lung, liver, kidney, and bone marrow transplantation.
Dallas Veterans Affairs Medical Center
The Dallas Veterans Affairs Medical Center is the central piece of the VA North Texas Health Care System, the VA’s second largest health care system. The hospital has 289 acute care beds and one of the largest VA dialysis units in the country.
Children's Medical Center Dallas
- Level 1 Pediatric Trauma Center
- Major Pediatric Kidney, Liver, Intestine, Heart, and Bone Marrow Transplant Center
- 487 Beds
- Primary Pediatric Teaching Hospital
- One of the Nation's Top Pediatric Hospitals
- Scholarly Activities
Fellows' Scholarly Activities
In addition to direct patient care responsibilities in a variety of clinical settings, the fellow will be provided with a variety of didactic lectures and learning experiences. Extensive library materials and services are available to the fellow at the UT Southwestern/ Parkland Hospital and Dallas VA Medical Center. Fellows will also have dedicated time for scholarly activities set aside.
Attendance at National Meetings
Fellows are encouraged to attend national meetings relevant to hospice and palliative medicine and are also provided CME funds to do so.
Didactics
Fellows begin their year with orientation “Boot Camp” when the faculty provide a basic lecture series and introduction to the program prior to starting rotations. After that, dedicated lecture series will occur every Thursday afternoon, covering core topics in Hospice and Palliative Medicine. These Thursday academic afternoons are protected from clinical and pager duties.
Quality Improvement Project
Fellows will meet regularly with faculty mentors over the course of the year to gain the skills, knowledge, and tools necessary to lead quality improvement projects and change initiatives designed to improve patient outcomes. Fellows will work together in groups complete a quality improvement project over the course of the year.
Faculty Mentor
Fellows will be assigned a faculty mentor. Fellows and their mentors meet quarterly to address fellow concerns and wellbeing, provide academic and clinical guidance, focused career planning, and a host of other topics.
Texas Consortium of Hospice and Palliative Medicine
The Texas Consortium of Hospice and Palliative Medicine is a network of palliative care programs that started in 2021. Fellows from this network of palliative care programs meet twice monthly for virtual journal club and didactics. The consortium also hosts an annual retreat. All fellows will be excused from clinical duties and will travel to meet with fellows from other palliative care programs from all over Texas. The hope of the retreat is to facilitate professional development and networking.
- Current Fellows
Meet our amazing team of fellows upon which our training program is built.
Raaga Bean, D.O.
- Hometown: Plano, TX
- Undergraduate School: University of Texas at Austin
- Medical School: William Carey University College of Osteopathic Medicine
- Residency: University of Texas Health Science Center at Tyler, Internal Medicine
Caitlin Creel, M.D., M.P.H.
- Hometown: DeQuincy, LA
- Undergraduate School: Louisiana College in Pineville, LA
- Medical School: Louisiana State University Health Science Center - New Orleans, LA
- Residency: University of Tennessee Health Science Center, Pediatrics
Shanup Dalal, M.D.
- Hometown: Houston, TX
- Undergraduate School: University of Texas at Austin
- Medical School: UT Southwestern
- Residency: UT Southwestern, Med-Peds
Vidhi Makanji, M.D.
- Hometown: Plano, TX
- Undergraduate School: Southern Methodist University
- Medical School: UT Health Science Center San Antonio
- Residency: UT Southwestern, Pediatrics
Rachel Naramore, M.D.
- Hometown: Johnson City, TN
- Undergraduate School: University of Tennessee - Knoxville
- Medical School: University of Florida College of Medicine
- Residency: University of Alabama Birmingham, Internal Medicine
Sarah Zamamiri, D.O.
- Hometown: Greensboro, NC
- Undergraduate School: University of North Carolina-Chapel Hill
- Medical School: Nova Southeastern University College of Osteopathic Medicine
- Residency: Henry Ford Hospital, Emergency Medicine
- Fellowship Faculty
- Parkland Health
Assistant Professor, Internal Medicine
- Clerkship Co-Director, Medical Student Palliative Care Rotation
Assistant Professor, Internal Medicine
- Clerkship Director, Fellowship Parkland Memorial Hospital Palliative Care Consult Rotation
Associate Professor, Family and Community Medicine and Internal Medicine
Assistant Professor, Family and Community Medicine and Internal Medicine
Assistant Professor, Internal Medicine
- Clerkship Director, Fellowship Community Hospice Rotation
Professor, Internal Medicine
- Associate Program Director, Internal Medicine Residency Program
Assistant Professor, Internal Medicine
- Medical Director for Hospice and Palliative Medicine
Assistant Professor, Internal Medicine
- Program Director, Palliative Care Fellowship Program
Sepedeh Hazrati, LCSW
Bereavement Coordinator
Eric Markinson
Chaplain
- Clements University Hospital
Assistant Professor, Internal Medicine
Assistant Professor, Internal Medicine
Assistant Professor, Internal Medicine
Assistant Professor, Internal Medicine
- Clerkship Co-Director, Medical Student Palliative Care Rotation
- Associate Program Director, Palliative Care Fellowship Program
Assistant Professor, Internal Medicine, Family and Community Medicine
- Dallas Veterans Affairs Medical Center
Professor, Internal Medicine
- Associate Program Director, Hematology Oncology Fellowship Program
Assistant Professor, Internal Medicine
Assistant Professor, Internal Medicine
Assistant Professor, Internal Medicine
- Children’s Medical Center Dallas
Assistant Professor, Pediatrics
Assistant Professor, Pediatrics
Assistant Professor, Pediatrics
- Director of Palliative Care
- Associate Program Director, Palliative Care Fellowship Program
Assistant Professor, Pediatrics
Assistant Professor, Pediatrics
Assistant Professor, Pediatrics
- Children's Medical Center Dallas: Long Term Care
Associate Professor, Pediatrics
- Chief, Division of Pediatric Respiratory Medicine
Professor, Physical Medicine & Rehabilitation
- Cook Children’s Hospital
Medical Director of Palliative Care
Associate Medical Director of Palliative Care
- Parkland Health
Contact Us
Assistant Professor
Associate Program Director, Adult Track
Assistant Professor
Associate Program Director, Pediatric Track
