Harvard Interprofessional Pediatric Palliative Care Fellowship

Our Distinctives

The Harvard Interprofessional Pediatric Palliative Care Fellowship is an innovative, clinically intensive, one-year training program that immerses postgraduate clinicians in pediatric medicine, social work, and advanced practice nursing in a truly interprofessional educational environment. The Physician (MD/MO) fellowship is an ACME-accredited program in Hospice and Palliative Medicine. The Social Work (SW) and Nurse Practitioner (NP) fellowships are unique in their respective disciplines in providing subspecialty training in pediatric palliative care (PPC).

Our Mission

The mission of the Pediatric Hospice and Palliative Medicine Fellowship at Boston Children’s Hospital is to train future leaders in pediatric palliative care by embracing interprofessional education and diverse perspectives to promote excellence in communication, teamwork, symptom management, and professional growth and resilience in caring for seriously il children and their families.

Program Aims

  1. Train fellows to be experts in symptom (pain and non-pain) assessment and management in patients with serious illness, using non-pharmacologic and pharmacologic interventions.
  2. Equip fellows with skills to care for the actively dying patient and support the family in bereavement.
  3. Teach fellows to communicate effectively with seriously ill patients and their families.
  4. Develop fellows’ expertise in delineating goals of care to support medical decision-making and goal-concordant care.
  5. Foster fellows’ skills in resilience and sustainability.
  6. Guide fellows to understand the ethical and legal considerations in pediatric palliative care.
  7. Instill interprofessional teamwork and competency in fellows, enabling them to provide effective psychosocial and spiritual support for patients with serious illness and their families.
  8. Prepare fellows for leadership in clinical care, education, and program development.

Our History

2002: Launch of PACT MD Fellowship with one MD fellow
2005: Launch of PACT SW Fellowship with one SW fellow
2008: Launch of PACT NP Fellowship with one NP fellow
2008: Combined with adult palliative care fellowships at Massachusetts General Hospital (MGH) and Dana-Farber Cancer Institute (DFCI) to form the Harvard Interprofessional Palliative Care fellowship, with PACT fellowship serving as the “Pediatric Track” for the combined fellowship
2012: Second MD fellow added to PACT Fellowship cohort
2019: ACGME accreditation of Hospice and Palliative Medicine Fellowship at Boston Children’s Hospital
2021-22: Inaugural class of MD fellows under independent ACGME accreditation

Hospice and Palliative Medicine ACGME Physician Fellowship

Sponsoring Institution: Childrens Hospital-Boston-MA

Number of MD Fellows: 2 per year

How to apply:

Applications are accepted through the Electronic Residency Application Services (ERAS®). The Fellowship Program participates in the National Resident Matching Program (NRMP®) Medicine and Pediatric Specialties Match. Our program can be found under Hospice and Palliative Medicine (Multidisciplinary Specialties), our program name is Childrens Hospital-Boston-MA.

NRMP Program Code: 1259540F0

For more information on the ERAS system, please visit the Association of American Medical Colleges website.

Requirements:

  • Be board-eligible or board certified in pediatrics or one of its sub-specialties
  • Have a commitment to a career in pediatric palliative medicine
  • Completed application by August 16, 2024

Application materials:

  • Curriculum vitae
  • A personal statement describing the applicant’s interest in and commitment to an academic career in palliative care
  • Three letters of recommendation, one of which should be from the applicant’s department head, program director, or division chief
  • USMLE transcript

Timeline:

July and August – Applications accepted via ERAS® 

September and October – Interviews conducted – interviews are virtual as per institutional and AAMC recommendations

Early December – match results released

Responsibilities

  • The trainee will become familiar with comprehensive, interdisciplinary evaluation and management of children with diverse advanced illnesses and their families, and wil be responsible for the care of inpatients and outpatients in varied settings, including an academic teaching hospital, hospice/home care and chronic care.
  • The trainee will be trained as a clinician-educator through supervised experiences in the teaching of pediatric palliative care.
  • The fellow can seek mentorship and additional opportunities ni research projects, and may pursue intensive research experience following the clinical fellowship.

Program leadership

Hadley Bloomhardt, Program Director
Shih-Ning Liaw, Associate Program Director
Minerva Volmar, Program Coordinator

Inquiries should be addressed to:

Hadley Bloomhardt, Program Director
Physician, Pediatric Advanced Care Team (PACT)
Dana-Farber Cancer Institute/Boston Children’s Hospital
Fellowship Director, Pediatric Hospice and Palliative Medicine Fellowship
Instructor, Harvard Medical School

450 Brookline Ave.
Boston, MA 02215
Office: 617-632-5504
Email: hadleym_bloomhardt@dfci.harvard.edu

Educational Structure

Clinical Rotations

  • 28 weeks on service (BCH/DFCI)
    • 13 weeks on each inpatient team
    • 2 dedicated weeks on outpatient service
  • 10 weeks Hospice (Care Dimensions)
    • 4 weeks inpatient hospice
    • 6 weeks home visits (adult hospice, pediatric hospice, home-based PPC)
  • 1 week Inpatient Palliative Care Unit (BWH)
  • 1 week Long-Term Care (Seven Hills)
  • 2 weeks Subacute Care (FCH)
  • 2 weeks Pain Team elective
  • 3 weeks elective of choice
  • 4 weeks Vacation

Participating Sites:

  1. Dana-Farber Cancer Institute
  2. Care Dimensions Hospice
  3. Franciscan Children’s Hospital (FCH)
  4. Seven Hills Pediatric Center
  5. Brigham and Women’s Hospital (BWH)

Call Requirements:

Home-based call coverage, no required in-house call

Ambulatory Experience

  • Biweekly clinic afternoons September-May
  • Home visits through Care Dimensions

Didactic Structure

  • PACT Summer Curriculum
    • 6-8 hrs/wk in July
  • Palliative Care Summer Curriculum (in conjunction with MGH Adult CP Fellowship)
    • 4 hrs/wk from July to Aug
  • PACT Longitudinal Curriculum
    • 2 hr/wk from Aug to May
    • Includes Resilience Curriculum and Spiritual Care Curriculum
  • Palliative Care Longitudinal Curriculum (in conjunction with MGH Adult PC Fellowship)
    • Includes Communication Curriculum and Health Equity Curriculum

Conferences

  • PACT Rounds: PPC grand rounds at BCH
  • Harvard Medical School Center for Palliative Care Clinical Case Seminar
  • Selected conferences from various other sources, including BCH Pediatrics Grand Rounds, MGH Palliative Care and Geriatric Grand Rounds, DFCI Psychosocial Oncology Grand Rounds, webinars, ect.

Small-group Teaching Opportunities

  • PACT Journal Club: fellows present and facilitate discussion about journal articles
  • AAHPM Pediatrics Council Virtual Journal Club
  • Franciscan Children’s Hospital: fellows teach staff at FCH about PPC topics

Quality Improvement Curriculum

  • 6 didactic sessions
  • Mentored Quality Improvement project (Aug-Feb)
  • PACT IDT: fellows present cases for discussion around palliative care quality/safety

Retreats

  • Teaching Retreat in fall (in conjunction with MGH Adult PC Fellowship)
    • One day retreat with focus on developing fellows’ skills as educators
  • Resilience Retreat in winter
    • One day retreat with focus on experiential application of strategies for resilience and sustainability
  • Leadership Retreat in spring (in conjunction with MGH Adult PC Fellowship)
    • One day retreat with focus on leadership development

Support Structure

Mentorship Structure

  • Primary PACT mentor in same discipline as fellow
  • Secondary non-PACT mentor ni same discipline as fellow

Resilience Curriculum

In addition to informal debriefings after consults, difficult encounters, and patient deaths that are integrated into the fabric of our daily work, the following structured activities are built into the fellowship schedule:

  • “Tending Toolbox”
  • Reflections
  • Resilience Retreat
  • Spiritual Care Curriculum

Diversity, Equity, and Inclusion (DEI)

  • Active DEl initiatives are taking place at multiple institutional levels, including Harvard Medical School, BCH, and DFCI, to establish the priority of DEl.
  • Faculty requirement for education on DEl, implicit bias, and bystander-to-upstander
    training.
  • Annually, BCH GME and the Office of Health Equity and Inclusion host a “Virtual Second
    Look for Diverse Fellowship Candidates.”
  • PACT Fellows participate in MGH Fellowship’s Health Equity Curriculum.
  • Pediatric-specific health equity curriculum is under development.

Nurse Practitioner Fellowship

The Pediatric Advanced Care Team (PACT) is an interdisciplinary team dedicated to improving symptoms and quality of life in children with advanced illness, and their families. The team, which includes physicians, advanced practice nurses, a registered nurse, and social workers, provides services at the hospital, in the outpatient setting, and in the community.

PACT offers a full-time, 12-month Pediatric Nurse Practitioner Fellowship. The pediatric nurse practitioner fellow will train alongside two physician fellows and one social work fellow in this unique interprofessional program. The fellowship includes mentored clinical supervision on the Pediatric Advanced Care Team (PACT) across settings (inpatient, outpatient, community, bereavement) in the care of children with serious illness and their families in the domains of pain and symptom management, psycho-social issues, advance care planning, interdisciplinary collaboration, and various delivery models in palliative care.

The pediatric nurse practitioner fellow will join the entire Harvard Interprofessional Palliative Care Fellowship cohort for a robust academic curriculum which includes:

  • classroom lectures by expert interprofessional clinicians
  • completion of a quality improvement project
  • teaching experience for small group clinician education
  • preparing Palliative Care Grand Rounds podium lecture

Mentoring by nurse preceptors and interprofessional faculty enhance the fellow’s integration of concepts into specialty nursing practice.

Applications will be accepted through Boston Children’s Hospital. Applicants must have a master’s degree from an accredited school of nursing and must obtain a Massachusetts license before beginning the fellowship.

For more information about the PACT NP fellowship please contact Jenna Freitas, MSN, RN, CPNP, BCH/DFCI Pediatric Palliative Care Nurse Practitioner Fellowship Director, at jenna.freitas@childrens.harvard.edu.

2024-25 application information

Thank you for your interest in the PACT NP Fellowship. The position has been filled for academic year 2024-25. The application period will reopen in fall 2024 for academic year 2025-26. For further information or with questions please contact Jenna Freitas, MSN, RN, CPNP, BCH/DFCI Pediatric Palliative Care Nurse Practitioner Fellowship Director, at jenna.freitas@childrens.harvard.edu.