Hospice & Palliative Medicine Fellowship

• Dr. Samantha Shapiro – Program Director 
• Dr. Manuel Moya – Associate Program Director 
• 3 full-time palliative care physicians
• 4 full-time advance practice registered nurses
• 2 full-time social workers
• 2 full-time nurses
• 1 full-time physician assistant 

Hartford Hospital

Hartford Hospital is an 867-bed tertiary care center with a Level 1 Trauma Center and is the primary training site for the fellowship. Fellows will be exposed to a wide range of pathology as Hartford Hospital frequently receives patients from other local and regional hospitals who need a higher level of care. Hartford Hospital offers heart, liver and kidney transplantation, as well LVAD implantation and ECMO. The hospital also has seven subspecialty intensive care units. 

Hartford Hospital serves a large and diverse patient population and there is a significant institutional focus on the social determinants of health. Outside of Hartford are several more rural and suburban areas with varied demographics, ensuring that fellows will gain experience caring for patients from diverse cultural and socioeconomic backgrounds. 

Fellows will have multiple rotations at Hartford Hospital, including the inpatient palliative care consult service, outpatient palliative care clinic, inpatient hospice, addiction medicine, radiation oncology, and pain pharmacy. 

The inpatient palliative care consult service consists of board-certified Hospice & Palliative Medicine physicians, advance practice registered nurses, physician assistants, social workers, and registered nurses. Last year the service received over 3400 new consults from a broad range of medical services and intensive care units.

The general inpatient (GIP) hospice team consists of hospice nurses, social workers and chaplains and cares for patients with severe symptoms that cannot be managed outside of an inpatient setting. The GIP hospice team enrolls over 500 patients annually.

The outpatient palliative care clinic was opened in January 2024 and has growth rapidly. Fellows will spend one half-day per week in clinic, caring for a cohort of ambulatory palliative care patients at various stages of their illnesses, with multiple physical, psychosocial, spiritual, and existential needs.

Hartford Healthcare (HHC) at Home Hospice

Hartford Healthcare at Home provides hospice care throughout the state of Connecticut. The fellows will spend their time in the Bloomfield region which has over 500 new admissions annually and an average daily census of 80 patients. The fellows will work closely with the hospice interdisciplinary team which consists of the hospice medical director, nurses, social workers, chaplains, hospice aides, bereavement counselors, and volunteers.

Connecticut Children’s Medical Center

Fellows will rotate for two weeks at Connecticut Children’s Medical Center, which is a 185-bed acute care pediatric hospital with a level 1 trauma center, and large neonatal and pediatric intensive care units. The pediatric palliative care team is a multidisciplinary team consisting of physicians, nurses, social workers, psychologists, chaplains, and other allied health professionals. The fellows will have the opportunity to see patients with a large spectrum of diagnoses, including genetic diseases, chronic diseases, and those who are nearing the end of life.

Long-term Care Rotation

Fellows will spend four weeks rotating at Seabury and Duncaster, two retirement communities in Bloomfield, CT that offer a full spectrum of living options, including independent living, assisted living, short-term rehabilitation, long-term care, and memory care.

Middlesex Hospice

The fellows will spend four weeks with the hospice medical director who oversees the home hospice program as well as running the inpatient palliative care and hospice unit at Middlesex Hospital. 

Academic Half Day

Fellows will have an academic half day every other week. This will be protected time free from clinical responsibility. Fellows will participate in a robust lecture series grounded in evidence-based medicine during these academic half days. Fellows will also participate in a journal club and sessions focused on resiliency and narrative medicine. In addition to ensuring that fellows graduate with the ability to treat the physical, psychological and spiritual suffering faced by patients with serious illness, we want our fellows to learn healthy and constructive ways to care for themselves. 

Fellows will be expected to progress from learners to teachers throughout the year, presenting at Case Conference and at Medical Grand Rounds. Towards the end of the year, fellows will have the opportunity to supervise residents rotating on the palliative care consult service, thereby allowing fellows to grow as clinician-educators. 

At a glance:

• Didactics: evidence-based lecture series
• Journal Club: held quarterly, fellows present once
• Grand Grounds: held quarterly, fellows present once
• Wellness / Resiliency: held quarterly
• Case Conference: held monthly, fellows present twice
• Narrative Medicine: held bi-annually

Northern New England Fellowship Collaborative

Fellows will participate in a three regional retreats with the HPM fellows from University of Vermont, Maine Medical, Dartmouth, Lahey Hospital, Yale. The first retreat will occur at the beginning of the year and will cover basic symptom management, communication skills and consultation etiquette.

The second retreat is held in the middle of the year and focuses on advanced communications skills, with VitalTalk as the model. Fellows will fine tune their ability to respond to emotion, share serious news, elicit goals and values, and recommend care plans. There will also be a workshop about Medical Aid in Dying (MAID) to ensure fellows understand the legal/ethical framework surrounding MAID in the US.

The final retreat will be held towards the end of the year and will focus on skills that will prepare fellows for success when transitioning into the role of attending. There will be sessions on triage, billing and coding, mitigating team conflict, and reflection on leadership and communication styles.

American Academy of Hospice and Palliative Medicine (AAHPM) Annual Assembly 

In the fall, fellows will submit a clinical case report abstract to the AAHPM. Fellows will attend the AAHPM Annual Assembly in the spring.

The Hospice and Palliative Medicine Fellowship at Hartford Hospital is approved to have two fellows per year. Applicants must have completed an ACGME accredited residency program in one of the following disciplines:

• Anesthesiology
• Emergency medicine
• Family medicine
• Internal medicine
• Neurology
• Obstetrics and gynecology
• Pediatrics
• Physical medicine and rehabilitation
• Psychiatry
• Radiology
• Surgery

Foreign medical graduates are welcome to apply and J1 visas will be supported. 

The HPM fellowship at Hartford Hospital will be accepting applications through the Electronic Residency Application Service (ERAS). Fellowship candidates can submit applications to our program from July 1 through August 30. Applications will only be reviewed once fully complete, and interviews will be offered on a rolling basis. Interviews will be held on set dates from September through November. We participate in the National Residency Match Program (NRMP). Match results are released in early December each year.

Program Application Requirements

• Dean's letter or MSPE from medical school
• Medical school transcript
• Three (3) letters of recommendation 
• USMLE Step I, II, and III or COMLEX-equivalent board scores
• Personal statement
• Curriculum Vitae as submitted through ERAS

NRMP Code: 1083540F0
ACGME Accreditation ID: 5400812001