LancasterGeneralHealth Family Medicine Residency Program

Curriculum/Training

 
Training sites include Lancaster General Hospital, Hospice & Community Care Inpatient Unit, continuing care retirement communities, assisted living facilities, skilled nursing homes, ambulatory care clinics and patient homes.
 
Core experiences: These are central to the practice of hospice and palliative medicine. 
 
  • Inpatient Hospice: The 24-bed free standing Inpatient Hospice Unit in Lancaster is the primary inpatient environment for some of the most seriously ill patients cared for by Hospice & Community Care. Most patients and families have multiple acute physical, emotional, social, practical, spiritual and loss issues. Fellow start their education learning to care for these complicated patients. Fellows spend one block of nine weeks and one block of 5 weeks on this rotation.
  • Home Hospice: Hospice & Community Care provides home hospice care for nearly 500 patients a day. Physicians visit patients and families dealing with complex symptoms/issues; collaborate with community physicians; serve as resources for nursing staff; and participate in weekly interdisciplinary home hospice team meetings. Fellows become integral members of their Home Hospice teams. The fellows spend one block of two months on Home Hospice rotation.
  • Long Term Care: Fellows’ long-term care experiences include consultations at selected extended care facilities. Special attention is given to the unique opportunities and challenges associated with providing hospice care in the long-term care environment. Additional experiences in palliative medicine visits in long-term care may be added as well. The fellows spend one block of one month on this rotation.
  • Palliative Medicine Consultations: Lancaster General Hospital is home to a busy and thriving hospital based palliative care service.  The Palliative Care Service team consists of a faculty attending physician, nurse practitioner, dedicated palliative care social worker and dedicated chaplain team members as well as a chaplain resident.  The fellow gets deep experience in running family meetings, negotiating goals of care and simplifying plans of care in critical care, cardiology, oncology and general medical patients.    The fellow attends weekly interdisciplinary team meetings for the palliative care consult team at Lancaster General Hospital.  The fellow is part of this team for two blocks of time, the first being 8 weeks in duration and the second being 5 weeks in duration.
Other rotations contribute to a well-rounded fellowship experience.
 
  • Elective: Rotations are available with selected faculty specializing in radiation oncology, infectious disease, outpatient pain management and addiction medicine.
  • Scholarly Activity: During this rotation, fellows learn some administrative aspects of hospice and palliative care. During this rotation, fellows participate in quality assurance and performance improvement activities with Lancaster General and Hospice & Community Care. Fellows complete their scholarly project time during this month. 
  • Ambulatory Care: Fellows have longitudinal rotations in an outpatient oncology clinic and in an outpatient radiation oncology. These experiences occur biweekly for six months. The attending oncologist has extensive experience in palliative medicine, including 10 years as a hospice medical director. The cancer center also provides a multidisciplinary team to ensure optimal care for cancer patients. The radiation oncology group has vast expertise in providing palliative radiation.