Clinical Training

Our fellowship has three core sites: the Palo Alto VA, Santa Clara Valley Medical Center, and Stanford Hospital. Fellows spend 10 weeks at each core site working with interdisciplinary teams as part of a consult team, or, in the case of the Palo Alto VA, the primary team.

The Palo Alto VA Inpatient Palliative Care Unit is unique in that fellows lead the inpatient hospice team managing acute symptoms and medical needs of patients with serious illness approaching the end of their life. Fellows are responsible for all aspects of patient care (admissions, ongoing management, interaction with all other subspecialties, coordination of care with social work, nursing, psychology, and case management, discharge coordination, bereavement care and provision of family support) with the support of faculty. Fellows and alumni have emphasized how valuable this unique experience is to their fellowship training.

Fellows also spend one month on home hospice, 2 weeks with geriatric psychiatry at the Menlo VA, 2 weeks with pediatric palliative care at Lucille Packard Children’s Hospital (LPCH), 2 weeks of outpatient palliative medicine at Stanford, and have at least 6 weeks of elective time where they can explore additional interests. We are hoping to launch a VA outpatient palliative rotation in 2025 which will include embedded clinics in oncology and an ALS clinic.

Elective options include but are not limited to acute and chronic pain, acute rehab spinal cord injury, addiction, ethics, geriatrics, geriatric-psychiatry, home based senior care, outpatient palliative at multiple sites, neuropalliative care, pediatric palliative, palliative care consults at Kaiser Redwood city, psychiatry, and psycho-oncology. 

The Palo Alto VA palliative continuity clinic sessions are on Monday mornings, and fellows are together for didactics in the afternoon. This allows fellows to have continuity at their rotation sites for the rest of the week and minimize half days away when possible. In July 2024, we are also launching continuity clinics at Stanford where each fellow is paired 1:1 with a faculty attending. Fellows will spend half the year at each continuity site.