Hospice and Palliative Medicine Fellowship

Hospice and Palliative Medicine Fellowship

About the Program

“Cultivate compassionate, physician leaders that can improve the quality of life for the seriously ill patient and their family through exceptional skill, communication, and advocacy.”

  - The AdventHealth Hospice and Palliative Medicine Fellowship Mission statement

During this year-long fellowship, fellows will be exposed to excellent leaders that will role-model and create unique experiences in advanced illness management. These specialties include the Advanced Heart Failure Transplant and LVAD Teams, Oncology teams within the AdventHealth Cancer Institute, Bone Marrow Transplant team, Critical Care Medicine, Neuro-critical Care, Advent Health's Organ Transplant Institute and the Coordinated Care for Kids Program with AdventHealth Orlando for Children. The Adventist Health System family includes the large Tertiary Care AdventHealth Orlando campus and AdventHealth Hospice, which serve a socially diverse and culturally rich population.

The focus of the Hospice and Palliative Medicine Fellowship Program is to embody and model the medical, spiritual, and psychosocial dimensions in patient and family-centered care. Our commitment is to train distinguished candidates who will excel as future leaders in the specialty of Hospice and Palliative Medicine.

Dominick Mastroianni, MD
Program Director
A message from our Program Director

Hello, I am excited that you are considering the AdventHealth HPM Fellowship. HPM is a gift that allows us to help the most vulnerable and seriously-ill patients, as well as be invited into the lives of patients and their families during the most difficult time. I hope you find that gift as rewarding as I do.

At AdventHealth HPM Fellowship you will find a location rich with experience opportunities and full of potential for personal growth. I am dedicated to provide you with tools to become excellent clinicians, leaders, and advocates for our patients no matter which area of HPM you choose to focus.

As part of one of the largest healthcare systems in the US, we have plenty of opportunities for you to grow with us after fellowship.

Also, do not be fearful that we are a young program. Our Orlando campus, which has become a major tertiary facility for much of the Southeast, Caribbean, and South America, started as humble farmhouse. We are used to growing! AdventHealth is a faith-based organization but we are welcoming of providers of all beliefs. Part of our team’s strength is our diversity. Please feel free to contact me with any questions.

Sincerely,
Dom Mastroianni

Faculty

of AdventHealth Medical Education

  • fpo1
    Okorie N. Okorie, MD
    Dr. Okorie is board certified in critical care medicine and hospice and palliative medicine, currently working at AdventHealth Orlando as a critical care intensivist. Dr. Okorie graduated from medical school at the College of Health Sciences at University of Calabar in Nigeria. He completed internal medicine residency training at Orlando Regional Medical Center and fellowship training in critical care medicine at Cooper University Hospital in Camden, NJ. Dr. Okorie previously served as program director for Orlando Health’s critical care medicine fellowship, as well as attending physician in critical care and internal medicine and Medical Education Simulation Director at Orlando Health.
  • fpo1
    Dominick Mastroianni, MD
    Program Director
    Dr. Dominick Mastroianni received his medical degree from the University of South Florida. He trained in Internal Medicine at Wake Forest Baptist Medical Center and completed his H&PM Fellowship at University of Alabama at Birmingham. He is a member of the American Academy of Hospice and Palliative Medicine. He has been on staff at AdventHealth Orlando since 2011. He has worked on improving system Palliative Care practices, including a multiple hospital-wide update and implementation on advance directives and code status within a large Healthcare System, as well as in the community through the Conversation Ready Project in Winter Park. He has worked in education through interactive workshops and electives with Internal Medicine, Critical Care Medicine, Family Medicine, and Geriatrics. He leads the AdventHealth Orlando Hospice and Palliative Medicine Fellowship.
  • fpo1
    Eric Moore, MD, MBA
    Dr. Moore received his Bachelor of science degree from Oakwood University in Huntsville Al., He completed his MD degree at the Medical College of Georgia in Augusta, Georgia, he completed his internship and residency at The AdventHealth Orlando Family Medicine Residency Program. He served as Family Medicine Faculty for the MD program at AdventHealth Orlando and preceptor faculty for the AdventHealth Orlando DO program. Dr. Moore completed 11 years of private Family Practice before becoming the Chief Medical officer for Hospice of the Comforter and currently serves as its Executive Medical Director. He is board certified in Family Medicine and Hospice and Palliative Medicine. Dr. Moore has also completed an MBA Degree from Webster University. He has been married for 19 Years and has 2 children 15 and 12 years old. Dr. Moore has a passion for end of life care and enjoys educating the community about the benefits of hospice services.
  • fpo1
    Alex Lavigne, DO
    Dr. Lavigne is a board-certified hospice and palliative medicine physician. He earned his Doctor of Osteopathy degree from Nova Southeastern University in Fort Lauderdale. He completed his internal medicine training at the Carolinas Healthcare System - Blue Ridge program in North Carolina. He is a member of the American Osteopathic Association and the American Academy of Hospice and Palliative Medicine.
  • fpo1
    Laurie Anderson, MD
    Dr. Laurie Anderson is board certified in Family Medicine and board-eligible for Hospice and Palliative Medicine. Dr. Anderson completed her Family Medicine training at the University of Louisville School of Medicine and went on to a Hospice and Palliative Medicine Fellowship at MD Anderson Cancer Center in Houston, TX. Dr. Anderson joined the AdventHealth Orlando Palliative Medicine consult service in July 2018.
  • fpo1
    Maria R. Gonzalez, MD, FAFP, CMD
    Dr. Maria Gonzalez is triple board certified in Family Medicine, Geriatric Medicine, and Hospice and Palliative Medicine. Originally from the Dominican Republic, Dr. Gonzalez trained in the AdventHealth Orlando residency program. Post residency training, she has worked in Graduate Medical Education at both the residency and fellowship level. Prior to joining the Palliative Care Team at AdventHealth Orlando, Dr. Gonzalez was the Medical Director of a continuum care retirement community in Live Oak, Florida. Currently Dr. Gonzalez is a physician with the inpatient Palliative Care consult team and core faculty for the Hospice and Palliative Medicine Fellowship.
    • fpo1
      Okorie N. Okorie, MD

      Dr. Okorie is board certified in critical care medicine and hospice and palliative medicine, currently working at AdventHealth Orlando as a critical care intensivist. Dr. Okorie graduated from medical school at the College of Health Sciences at University of Calabar in Nigeria. He completed internal medicine residency training at Orlando Regional Medical Center and fellowship training in critical care medicine at Cooper University Hospital in Camden, NJ. Dr. Okorie previously served as program director for Orlando Health’s critical care medicine fellowship, as well as attending physician in critical care and internal medicine and Medical Education Simulation Director at Orlando Health.

    • fpo1
      Dominick Mastroianni, MD
      Program Director

      Dr. Dominick Mastroianni received his medical degree from the University of South Florida. He trained in Internal Medicine at Wake Forest Baptist Medical Center and completed his H&PM Fellowship at University of Alabama at Birmingham. He is a member of the American Academy of Hospice and Palliative Medicine. He has been on staff at AdventHealth Orlando since 2011. He has worked on improving system Palliative Care practices, including a multiple hospital-wide update and implementation on advance directives and code status within a large Healthcare System, as well as in the community through the Conversation Ready Project in Winter Park. He has worked in education through interactive workshops and electives with Internal Medicine, Critical Care Medicine, Family Medicine, and Geriatrics. He leads the AdventHealth Orlando Hospice and Palliative Medicine Fellowship.

    • fpo1
      Eric Moore, MD, MBA

      Dr. Moore received his Bachelor of science degree from Oakwood University in Huntsville Al., He completed his MD degree at the Medical College of Georgia in Augusta, Georgia, he completed his internship and residency at The AdventHealth Orlando Family Medicine Residency Program. He served as Family Medicine Faculty for the MD program at AdventHealth Orlando and preceptor faculty for the AdventHealth Orlando DO program. Dr. Moore completed 11 years of private Family Practice before becoming the Chief Medical officer for Hospice of the Comforter and currently serves as its Executive Medical Director.

      He is board certified in Family Medicine and Hospice and Palliative Medicine. Dr. Moore has also completed an MBA Degree from Webster University. He has been married for 19 Years and has 2 children 15 and 12 years old. Dr. Moore has a passion for end of life care and enjoys educating the community about the benefits of hospice services.

    • fpo1
      Alex Lavigne, DO

      Dr. Lavigne is a board-certified hospice and palliative medicine physician. He earned his Doctor of Osteopathy degree from Nova Southeastern University in Fort Lauderdale. He completed his internal medicine training at the Carolinas Healthcare System - Blue Ridge program in North Carolina. He is a member of the American Osteopathic Association and the American Academy of Hospice and Palliative Medicine.

    • fpo1
      Laurie Anderson, MD

      Dr. Laurie Anderson is board certified in Family Medicine and board-eligible for Hospice and Palliative Medicine. Dr. Anderson completed her Family Medicine training at the University of Louisville School of Medicine and went on to a Hospice and Palliative Medicine Fellowship at MD Anderson Cancer Center in Houston, TX. Dr. Anderson joined the AdventHealth Orlando Palliative Medicine consult service in July 2018.

    • fpo1
      Maria R. Gonzalez, MD, FAFP, CMD

      Dr. Maria Gonzalez is triple board certified in Family Medicine, Geriatric Medicine, and Hospice and Palliative Medicine. Originally from the Dominican Republic, Dr. Gonzalez trained in the AdventHealth Orlando residency program. Post residency training, she has worked in Graduate Medical Education at both the residency and fellowship level. Prior to joining the Palliative Care Team at AdventHealth Orlando, Dr. Gonzalez was the Medical Director of a continuum care retirement community in Live Oak, Florida. Currently Dr. Gonzalez is a physician with the inpatient Palliative Care consult team and core faculty for the Hospice and Palliative Medicine Fellowship.

Fellows

    • fpo1
      Catalina Soto, MD
      PGY4/ Fell 1
    • fpo1
      Catalina Soto, MD
      PGY4/ Fell 1

Curriculum

Rotation Schedule
  • Inpatient Palliative Care: Consults and Palliative Care Unite (PC) 5 Blocks
  • Hospice: Inpatient Unit and Home Visits (Hosp) 3 Blocks
  • Pediatrics (Peds) 1 Block
  • Long Term Care (LTC) 1 Block
  • Advanced Pain and Heart Failure (Pain/HF) 1 Block
  • Oncology and Critical Care (Onc/CC) 1 Block
  • Elective 1 Block
Rotations

“The purpose of life is to live it, to taste experience to the utmost, to reach out eagerly and without fear for newer and richer experience.” ― Eleanor Roosevelt 

The AdventHealth Orlando Campus will be the cornerstone of your education because it provides a central collection of the sickest patients with challenging symptoms and most complex treatment options, while providing you the ease of less travel.

 

Palliative Care Consult

Much of your education will be at AdventHealth Orlando where you can experience the dilemmas of modern medicine with a dedicated team including physicians, pharmacists, social workers, chaplains. Your time will be divided amongst the consult service and Palliative Care Unit. You will have the opportunity to work on a consult service with disease areas ranging from cancer, dementia, heart failure, lung disease, and cirrhosis amongst others. There is a Palliative Care Unit that provides a healing atmosphere with high level Palliative trained nursing staff. You will also have time at the AdventHealth Winter Park campus, which provides the experience of practicing in a community hospital.

 

Hospice

Since 1990, AdventHealth Hospice Care Central Florida (formerly known as Hospice of the Comforter) has provided end-of-life care and support to patients and their families throughout Orange, Seminole and Osceola counties. With care that is focused on comfort and quality of life, our services enable patients to live their lives to the fullest, surrounded by loved ones so that they might meet death with a sense of dignity—and so those left living may find peace and solace. AdventHealth Hospice Care’s campus is in Altamonte Springs, Florida, which includes a free-standing inpatient hospice unit with 16 private suites, as well as a 15-bed inpatient hospice unit on the campus of AdventHealth Orlando. Outside of your dedicated time with hospice you will also spend time with hospice during your Long-term Care and Pediatric experience to understand the benefits of HPM at all stages of life. You also will spend time with the home care team as well as at two of their state-of-the-art Inpatient Units, one of which is conveniently located on the Orlando Campus.

 

Palliative Care Clinic

Our Palliative Care clinic is led by Dr. Maria Gonzalez and includes a dynamic team of pharmacist and social worker. The clinic is currently a half day a week and is integrated throughout your work year.

 

Pediatrics

We are fortunate to have Dr. Amanda Bashir help lead our Pediatric Palliative Care program. You will work along with her at the AdventHealth Children’s Hospital, housed on the Orlando Campus. There is often trepidation amongst adult physicians in dealing with sick children. We will provide a safe experience unique to each fellow’s comfort.

 

Long-term Care

This rotation will focus on treating the seriously-ill in the highly regulated area of nursing homes. You will team up with the Geriatric Fellowship team. The rotation will include experiences in the Geriatric clinic and care at the Mayflower and the Gardens at DePugh, which are within 3.5miles of the Orlando campus. The Mayflower is a Continuing Care Retirement Community, which provides care ranging from independent living to skilled nursing. The Gardens at DePugh is a community SNF with a five-star CMMS rating. Part of you time will be spent from the perspective of primary physician in the NH and of the hospice team visiting the nursing home.

 

Oncology

The AdventHealth Cancer Institute is a Center of Excellence that sees over 4,000 cases per year. You will get the opportunity to work hand in hand with the oncology team, as well as experience radiation oncology and gynecologic oncology. Palliative Care, often termed Supportive Oncology, is a crucial part in extraordinary cancer care.

Quality Improvement and Research

You will have an opportunity to work on your own quality improvement project and submit a poster or presentation for the American Academy of Hospice and Palliative Medicine Annual Assembly. Locally you have the annual AdventHealth GME presentation day to submit to as well. This integrated research experience will utilize the established GME department’s research support team., which has been successful at winning several awards within the medicine, surgery, and radiology departments.

 

Pain Clinic / Interventional / Addiction Medicine

p>Unfortunately, those with substance use disorder also get serious illness. You will have the opportunity to learn best practice for safe care from our local substance use specialists. Especially during a time of an opioid epidemic and higher scrutiny, you want to have the tools to advocate for your pain patients.

 

Advanced Heart Failure/ Transplant / LVAD

You will have the opportunity to work with the AdventHealth Cardiovascular Institute where you will understand better the patient experience and treatment options of LVAD, transplant, and ECMO through the perspective of the cardiovascular team and palliative team.

 

Clinical Ethics

This will be integrated throughout your year and be led by bioethicist Dr. Dennis DeLeon. You will learn basic principle while applying them to real life with the ethics team as well as facinating case studies.

 

Didactics Activities

*HPM Grand rounds (weekly)

*Journal Club (monthly)

*Case Review (monthly)

*Research Seminar (monthly)

*Physician Wellness (6 weeks)

*Board Review (final 3 months of fellowship)

*FH Biomedical Ethics Meeting (monthly)

 

Lecture Topics 

Fellows will attend lectures provided by H&PM Faculty and other physician leaders on multiple topics including:

*Pathophysiology of pain and other symptoms

*Pharmacology of analgesics

*Pharmacological and non-Pharmacological management of pain and other symptoms

*Interventional pain medicine procedures

*Hospice

*Oncology

*Cardiology

*Neurology

*Critical Care

*Geriatrics

*Pediatric Palliative Care

*Clinical Ethics

*Prognostication

*Team Dynamics in the IDT

*Communication

*Family Care

*Spiritual Care

*Withholding and withdrawing life sustaining treatment

*Grief, loss and bereavement

*Quality Measures in Palliative Care

 

Research

Residents, fellows, and faculty involved in required GME scholarly activities receive guidance from the Center for Collaborative Research (CCR) through the Clinical Academic Research team, comprised of an Academic Research Mentor, a Project Coordinator, and a Regulatory Coordinator. In addition, the center includes a group of biostatisticians, a health economist, and a medical editor.

CCR assists residents, fellows, and faculty with all types of scholarly activities (case studies, QI projects and research studies), from study design and protocol development, to data analysis and poster, presentation or manuscript preparation.

Eligibility

What You'll Need

Applicants who have completed (or will complete) an ACGME approved residency in one of the following disciplines are eligible to apply:

  • Internal Medicine
  • Emergency Medicine
  • Family Medicine
  • Anesthesiology
  • Psychiatry
  • Neurology
  • Obstetrics and Gynecology
  • Pediatrics
  • Physical Medicine and Rehabilitation
  • Radiation Oncology
  • Surgery

Sample Resident Agreement

Eligibility & Selection Policy

  • For international medical graduates, verification of Educational Commission for Foreign Medical Graduates (ECFMG) certification.
  • Possess or be eligible for Florida Medical Licensure and DEA registration, along with AdventHealth Orlando Medical Staff privileges. These licensures are required before the anticipated date of matriculation.
  • Be able to abide by the rules of the AdventHealth Orlando Graduate Medical Education Department and AdventHealth Orlando.
  • Evidence of aptitude and interest in hospice & palliative care during residency training and/or practice with definite plans to include hospice & palliative care in the practice of medicine upon the completion of the fellowship program.
  • Excellent academic and clinical performance in residency training defined on the basis of standardized examination scores and clinical evaluations.
  • Excellent leadership skills demonstrated in residency training or practice.

Benefits

We'll Take Care of You

Education Allowance

Fellows will receive up to 5 days of paid leave to attend and present at conferences with CME expenses reimbursed up to $1500.

Salaries

PGY 4 - $60,257.60

PGY 5 - $62,316.80

PGY 6 - $65,416.00

PGY 7 - $68,494.40

Professional Fees

Florida State Medical License and DEA license fees will be covered by the program. The cost of certification classes, such as ACLS, are covered as necessary for meeting program requirements.

Physician Wellbeing

For more information on the many benefits offered across all programs, click here.

Application Process

Join Our Fellow Team

For application to our fellowship program,

Application

Directions

2501 N. Orange Avenue
Orlando, FL 32804

  • From the airport
    Take the North Exit Take 528 West (Toll $2.25) Take 1-4 East to Orlando Take the Princeton Exit (#85) Turn right on Princeton St Turn left on North Orange Ave Take the 2nd right onto East Rollins St
  • From the Tampa area:
    Take 1-4 East to Orlando Take the Princeton Exit (#85) Turn right on Princeton St Turn left on North Orange Ave Take the 2nd right onto East Rollins St
  • From the Daytona area:
    Take I-4 West to Tampa Take the Princeton Exit (#85) Turn left on Princeton St Turn left on North Orange Ave Take the 2nd right onto East Rollins St
Once on Princeton:
Make a left at Orange

For hospital parking garage entrance, turn right at King Street

Mindi Apicella

Fellowship Coordinator

407-303-5951407-303-7323 2501 N. Orange Ave Suite 235 Orlando, FL 32804