Trainee Position Description and Essential Functions

This is unpublished

Position Identification: Fellow

Position Summary:

The University of Washington Hospice and Palliative Medicine Fellowship is a 12-month ACGME-accredited clinical training program designed to prepare physicians for a career in palliative medicine. The mission of the program is to foster the development of a diverse group of graduates who can succeed in any clinical, educational, or academic role in the scope of palliative medicine, while maintaining resilience and professional fortitude.

Fellows receive comprehensive interdisciplinary training across inpatient, outpatient, hospice, and community settings. Clinical training occurs at Harborview Medical Center, VA Puget Sound Health Care System, University of Washington Medical Center, Fred Hutch Cancer Center, and affiliated community sites, with experience in palliative care consultation, serious illness communication, symptom management, goals of care, and hospice medicine. Fellows do not take in-house call, and the majority of the program takes place on a Monday through Friday schedule.

Program goals include training highly skilled palliative medicine physicians through broad clinical exposure and evidence-based practice, developing expertise in the core principles of palliative medicine, and preparing fellows to become future leaders and innovators in the field through structured didactics, mentorship, scholarly activity, and teaching opportunities.

For the purpose of this document, the term “Resident” includes medical and dental residents and fellows, including those in ACGME, CODA and non-ACGME accredited programs.

General Overview of the Resident Role

A resident’s responsibilities include patient care responsibilities within the scope of their clinical privileges commensurate with level of training and other responsibilities required of all members of the medical staff. Under the supervision of attendings, general responsibilities of the resident may include:

  • Initial and ongoing assessment of patients’ medical, physical and psychosocial status
  • Performing history and physical examination
  • Developing assessment and treatment plan
  • Performing rounds
  • Recording documentation, including progress notes, admission notes, procedure notes and discharge summaries
  • Ordering tests, examinations, medications and therapies
  • Arranging for discharge, referral and after care.
  • Providing patient education and counseling about health status, test results, disease processes and transition of care planningTeaching and evaluating junior learners, such as medical students and residents

UW GME Expectations for Professional Behavior

Essential Functions

Essential functions are the fundamental job duties of the position that cannot be eliminated or substantially modified without changing the nature of the position.

A job function may be considered essential for the following reasons:

  • The reason the position exists is to perform that function
    • Resident educational requirements and patient care responsibilities
  • A limited number of available residents can perform that function
  • Varies by program, rotation, year, risk pools, etc.
  • The function may be highly specialized so that the trainee in the position is hired for their expertise or ability to perform the particular function
    • Cannot easily hire more trainees, especially of a specific R level
  • The percentage of time spent on a function does not determine whether or not it is essential.

Essential functions for GME residents must include consideration of:

  • ACGME program requirements
  • Specialty board requirements
  • UW program requirements
    • Unique to each UW training program and must consider:
      • Complexity of rotations/service requirements
      • Size of program
      • Structure and depth of risk pools
      • Please refer to the program’s Clinical Coverage Policy
    • Inclusive of the hospital system requirements:
      • Rotations dependent on residents’ service for patient care
      • Coverage options available

A resident must perform the position’s essential job functions with or without an approved reasonable accommodation. Reasonable accommodation means modifying or adjusting practices, procedures, policies, job duties, or the work or application environment so that a qualified individual with a disability can still perform a position’s essential functions. Approved reasonable accommodations are determined via an interactive process involving the resident, DSO/HR/GME and the program.

Essential functions ensure the safe and smooth delivery of education and patient care and are identified in alignment with program aims to facilitate trainee readiness for independent practice across an appropriate range of clinical settings for that specialty. Transparent documentation of a program’s essential functions is also an important resource for applicants evaluating the training program during recruitment.

Essential Program Administrative Functions

Onboarding

The Resident must:

  • comply with all program and institutional tasks required for credentialing and onboarding by the requested deadlines

Program Tasks and Documentation

The Resident must:

  • participate in all requests for schedule preferences, requests for absence or schedule changes on the requested timelines or deadlines.
  • complete in a timely manner all evaluations requested for medical students, peer residents, faculty or other members of the team
  • complete MedHub clinical and educational hour logs
  • complete case or procedure logs
  • complete the annual ACGME Resident Survey
  • complete the program’s annual confidential internal survey
  • attendance at all required program meetings, including semiannual meetings, mentorship meetings, monthly program meetings, program retreats, etc.

Essential Program Core Educational Functions

Didactics

The Resident must:

  • Comply with all standards for attendance at didactics or other core educational activities
  • Adhere to the preferred mode of attendance (in-person, virtual, hybrid)

Scholarship

The Resident must:

  • Comply with all program or specialty requirements for research or scholarship, quality improvement, conference presentations, teaching and presentations internal to the program (e.g. journal club, didactics, case conference, M&M, etc.)

Essential Patient Care Functions

Presence and preparedness

The Resident must:

  • present to work as physically, mentally and emotionally fit for duty
  • arrive at the patient care setting on schedule
  • arrive at work in attire appropriate for the safe delivery of patient care
  • meet expectations for chart review or pre-rounding
  • satisfy expectations that precede sign-out and/or departure from the clinical setting, including an appropriate handoff and follow up on all patient assessments/data/studies that will alter care in the near term.

Administrative

The Resident must:

  • complete patient health record documentation on the schedule prescribed by the program or medical center. (Examples include but are not limited to progress notes/visit summaries, consult notes, etc)
  • comply with expectations for EHR inbox management, including timely responses to messages from patients and medical staff as well as tracking and patient follow up of expected results

Patient Care Communication

The Resident must:

  • respond in a timely manner to pages, phone calls and electronic health record messages
  • check physical inboxes for paper records (e.g., letters, faxes) regularly per site policy

Patient Care Volumes

The Resident must:

  • work toward (with supervision) or meet benchmarks for patient care volumes in all clinical settings
  • appropriately request and utilize supervision

Consultation

The Resident must:

  • appropriately respond to, triage, and staff consultations in a timely manner
  • document findings and recommendations in a timely manner
  • communicate with the requesting service directly (e.g. in-person, phone) in advance of and following the assessment
  • ensure that consultations are staffed and finalized with a faculty member in a timely manner

Essential Shift and Schedule Functions

Settings

  • complete assigned shifts in settings deemed essential by the program, such as inpatient units, outpatient specialty and primary care clinics, hospice home visits, and skilled nursing facility visits

Shift length and timing

The Resident must:

  • Complete shifts of all lengths deemed essential by the program. The vast majority of shifts are weekday shifts. The fellows are required to participate in 2 Saturday’s per year of Vital Talk training (and pediatric fellow call as listed below).
  • Shifts must not exceed ACGME limits of up to 28 hours per shift, and up to 80 hours per week averaged over a 4 week period
  • where appropriate, comply with designated break lengths (to meet personal needs and not impact patient care)

Call Responsibilities

The Resident must:

  • No required call. The resident may complete overnight home call and/or in house weekend call as an optional opportunity for learning.
  • Pediatric fellows take two weeks of Acting Attending night call and work two weekends per year

Essential Cognitive Functions

  • Analyze, synthesize, and apply knowledge from clinical experience, readings, and didactic learning to support clinical decision-making.
  • Develop and demonstrate sound clinical judgment in diagnosis, treatment, and prevention of illness.
  • Identify, prioritize, and manage patient care and professional responsibilities to support safe, timely, and effective outcomes.
  • Apply clinical reasoning effectively in situations involving uncertainty and changing conditions.
  • Seek guidance and incorporate input from others as appropriate to support patient care and professional development.
  • Reflect on performance and integrate feedback to support continuous improvement.
  • Adapt to evolving clinical environments and changing patient care needs.
  • Demonstrate reliability through consistent participation in responsibilities and timely completion of assigned tasks.
  • Operate effectively in dynamic clinical environments with frequent interruptions and competing priorities.
  • Provide guidance, support, and teaching to junior learners, including medical students

Essential Communication Functions

(including verbal and written)

  • Gather, interpret, and exchange information effectively with patients, families, and members of the healthcare team.
  • Communicate clinical information clearly and in a patient-centered manner to support
    understanding and shared decision-making.
  • Facilitate safe and effective transitions of care, including handoffs, discharges, and referrals.
  • Communicate care plans and updates to appropriate members of the healthcare team to ensure continuity and quality of care.
  • Recognize and respond appropriately to the perspectives, needs, and emotions of others.
  • Collaborate effectively with members of the healthcare team across roles and settings to support coordinated, high-quality care.
  • Engage respectfully with individuals from diverse social, cultural, and lived experiences.
  • Contribute to a professional, inclusive, and respectful care and learning environment.

Essential physical functions

(including senses, stances and mobility, manipulation and technical skills)

  • Conduct patient assessments to gather and interpret clinical information, supporting comprehensive medical and psychosocial evaluation.
  • Sustain performance of clinical responsibilities over scheduled shifts to ensure continuity and quality of patient care.

Statement Of Nondiscrimination

The University of Washington prohibits discrimination, harassment and sexual misconduct in any education program or activity that it operates. Individuals may report concerns, make complaints, or direct inquiries to the Civil Rights Compliance Office. View the Statement of Nondiscrimination.

This document reflects requirements, established practices, policies, procedures, and resources as of the date of publication; however, parts of this document may be updated from time to time in accordance with changes in the law and applicable requirements, established practices, policies, procedures, and resources. Continued participation by a resident in the program will demonstrate agreement by the resident to adhere to the updates. The program will communicate such change to residents and prospective applicants.