Hospice and Palliative Fellowship

Docters talking in a clinic

The hospice and palliative medicine fellowship program provides a rigorous and interdisciplinary fellowship in hospice and palliative medicine. The fellowship trains physicians in palliative care which aims to reduce the burdens of life limiting conditions by supporting the best quality of life.

Our program was established in 2008 and has full ACGME accreditation. This is a small and close-knit fellowship with strong faculty support. The fellowship is committed to diversity in training and education. Our fellows have come from varied career paths including new graduates, mid-career and multi-career physicians, internists, family practitioners, physiatrists, anesthesiologists, M.D.s and D.O.s. We accept three fellows per year.

The hospice and palliative medicine fellowship program is designed to further training in the management of factors that contribute to the suffering of the patient and the patient's family through the course of the illness. The fellowship experience includes acquiring the central skills of providing assistance with medical decision-making, prevention (when possible), assessment and management of physical, psychosocial and spiritual distress faced by individuals and their families.

Notable hospice and palliative medicine program features, per ACGME requirements, encompass the following:

  1. High levels of expertise in addressing the multidimensional needs of people with life-threatening illnesses, including a practical skill set in symptom control interventions
  2. High levels of expertise in both clinical and non-clinical issues related to advanced illness, the dying process and bereavement
  3. Commitment to an interdisciplinary team approach
  4. Strong focus on the individual and family as the unit of care

If you are interested in applying to our hospice and palliative medicine fellowship program, please use the ERAS application.

For questions about the program, please contact Program Coordinator at (775) 327-5174.

Program Structure

The core of the hospice and palliative medicine fellowship curriculum is based on longitudinal HPM experiences that last the entire year. Each fellow will provide palliative and hospice care for adults and children. In addition, fellows may elect to attend subspecialty clinics focused on palliative care and chronic disease such as COPD, CHF, wound Care, home-based primary care and rehabilitation. Fellows follow a panel of patients at the VA Community Living Center where the focus is on interdisciplinary team care planning of complex chronic disease patients. This includes long-term care, palliative and hospice appropriate admissions. The fellow also participates in administrative meetings.

Educational Experience

Length of rotation by location
Rotation Length
VA Sierra Nevada Health Care Center
Inpatient HPM Consults &
Inpatient Hospice Care*
4 months
Community Living Center (CLC)
Skilled nursing facility*
1 month
Oncology 1 month
QI-Scholarly projects &Electives 2 months
Continuity Care for long stay nursing facility patients ½ day per week through entire academic year
Continuity Care for long stay nursing facility patients ½ day per week through entire academic year
Outpatient Palliative Care Clinic Two ½ days per week throughout academic year during noncore rotations
Renown Medical Center
HPM Consults 1 month
Oncology 1 month
Radiation Oncology / Pediatric Oncology 1 month
Home Hospice Rotation 1 month

*denotes Core Rotations

There are 12 one-month blocks of rotations for fellows at clinical sites which include inpatient, outpatient and nursing facility experience relevant to hospice and palliative medicine education. Rotations include administrative, clinical care, quality improvement, team care planning and house staff teaching duties. Fellows work with nurse practitioners, pharmacist, psychologist, social workers, rehab staff, chaplains, nutritionist and nurses on care planning and case management as part of an interdisciplinary team.

Didactic sessions are also provided by and for fellows through the following: live presentations, journal club, video teleconferencing (VTel), audio teleconferencing, webcasts and online-based educational sessions. To enrich and enhance collegiality among small fellowship programs, we offer the fellows increased exposure to other geriatric medicine fellows through a shared weekly core lecture with Stanford University's GRECC and their fellows. Some lectures occur in Reno and some occur in Palo Alto, California, but are broadcast live through VTel. The VA is a rich source of nationally acclaimed speakers that offer monthly research conferences through our live audio teleconferencing systems. Didactics are designed to fit different learning styles from those who are self-directed to those needing more scheduled lectures.

The fellowship program offers frequent close mentoring and collaborative opportunities for academic growth with HPM faculty.