Hospice and Palliative Medicine

NYU Winthrop Hospital is a 591-bed university-affiliated medical center which proudly offers sophisticated diagnostic and therapeutic care in virtually every specialty and subspecialty of medicine and surgery. We are a major regional healthcare resource with a deep commitment to medical education and research, offering a full complement of inpatient and outpatient services. We are also Nassau County’s only American College of Surgeons certified adult Level 1 Trauma Center with full adult and pediatric capabilities.

Rest assured that whatever medical care you or your family may need, NYU Winthrop is committed to a profound guiding principle: “Your Health Means Everything”

NYU Winthrop Hospital has been a focal point of academic medicine on Long Island and is now very proud to partner with the NYU Long Island School of Medicine, a newly LCME accredited, innovative 3-year medical school located on the hospital campus with a mission to educate exemplary physicians and academic leaders in primary care. In addition, we sponsor over 30 medical and surgical residency and fellowship training programs where 300 physicians have chosen to pursue their post-graduate medical education.

NYU Winthrop has a vibrant multi-faceted research program. As part of its mission as a teaching hospital, NYU Winthrop physicians and scientists are engaged in groundbreaking basic and clinical biomedical research.

Ever changing and growing with the diverse community it serves, NYU Winthrop Hospital is, in many ways, a unique institution, simultaneously large and small, regional as well as local. We successfully blend the progressive philosophy, sophistication and advances of a teaching and research institution with a very personal approach to patient care – an approach that has become the cornerstone of our organization.

View NYU Winthrop Hospital’s awards and recognitions

• The curriculum is innovative and comprehensive, and strongly emphasizes each of the following domains:
  • Highly integrated Interdisciplinary Team (IDT)
  • Expert-level pain and symptom management including training with faculty who are experienced in the use of Patient-Controlled Analgesia (PCA) , use of ketamine and methadone.
  • Participation on the Institutional Bioethics Committee, Clinical Ethics Case Consultation Service and Pain Committee.
  • State-of-the-Art Simulation Center for building clinical and communication skills.
  • A structured and extensive bioethics curriculum is integrated into the fellowship.
    • The program has a wealth of bioethics expertise with core faculty and clinical team members who have formal training and expertise in bioethics. Our fellows learn to apply bioethical principles and knowledge to their everyday clinical practice
    • Moral reasoning and Ethical Analysis (skill development)
    • Decision-making standards
    • Ethics of surrogate decision making
    • Ethical and professional aspects of consultative medicine
    • The Psychology of Decision Making

  In addition to our outstanding clinical training program, NYU Winthrop offers highly competitive salaries and tremendous benefits to our residents/fellows. An overview of salary, benefits and employment eligibility is available on the GME Office website.

• Educate fellows to manage complex moral and ethical challenges in palliative medicine, to provide the highest quality medical care.
• Train fellows in interdisciplinary team-based care so they can become effective leaders in healthcare.
• Produce independent palliative medicine physicians who excel at both medicine and doctoring.

Fellows will rotate through a wide range of clinical settings. These include inpatient, consultative and ambulatory palliative care services, home hospice, extended care and pediatrics. Fellows also receive four weeks of elective rotations, and time and support for scholarly/research activities.

Adult Palliative Care Inpatient Consultation Service

Ambulatory Palliative Care

• Site: NYU Winthrop Palliative and Supportive Care Clinic
• Goals: Develop skills to care for patients who have a wide range of prognoses and a variety of diseases. Patients are referred to the program from pulmonology, cardiology, neurology, pediatrics, oncology and gynecologic oncology.
• Site Director: Jeffrey Berger, MD
• Duration: One half day per week throughout the training year.

Home Hospice

Pediatrics and Extended Care

Inpatient Palliative care Unit

Elective

• Site/Faculty: Varies depending on fellow’s clinical interests
• Options: Dependent on the fellow’s goals. Elective rotations offered in Medical Oncology, Gynecological Oncology, Radiation Oncology, Pulmonary Hypertension and Pulmonary Fibrosis, Congestive Heart Failure, Wound Healing and Ethics.
• Duration: 1 month

In addition to clinical training, fellows participate in formal didactic activities throughout the year, including a regular lecture series, journal clubs and case discussions. The lecture series includes up-to-date scientific information on core topics in hospice and palliative medicine, and is taught by interdisciplinary and multidisciplinary faculty members from several departments within NYU Winthrop.

• Palliative Medicine Journal Club
  Fellows lead the quarterly interdisciplinary Palliative Medicine Journal Club, under supervision of a faculty member. They also collaborate with other Divisions including Pulmonary/Critical Care and Oncology for Inter-Divisional Journal Clubs.
• Core Curriculum Lectures
  We address symptom management, functioning as a consultant, grief and bereavement, spiritual assessment, communication skills, pediatric palliative care, and cultural aspects of palliative care with the leadership of highly trained and experienced interdisciplinary faculty. The Didactics are delivered in the adult learning model with an emphasis on active learning. View Fellows Core Lecture Topics.
• Palliative Care Interdisciplinary Team Meetings
  Every week, fellows join the staff of the NYU Winthrop Palliative Care Consultation Team to discuss clinical issues through clinical interdisciplinary conversation, and raise cases and issues that are complex.
• Palliative Care Division Grand Rounds
  These teaching conferences focus on a critical review of the palliative care literature and academic research presentations by regional and national leaders in the field of palliative care. Fellows also attend weekly Department of Medicine Grand Rounds.
• Simulation Sessions
  The fellows experience two separate SIM training scenarios during their fellowship. At the state-of-the-art Simulation Center, fellows improve their knowledge and develop the skills required for communication, providing individualized care and withdrawing of life-prolonging treatments.
• Board Review
• Palliative Care Self-Care Curriculum
  Fellows participate in fellow-only discussions facilitated by our Social Worker on faculty with expertise in the field. Fellows also participate in bimonthly meetings with the Program Director.
• Scholarly Project
  Fellows are required to develop a scholarly project as part of their training. The subject of the project will depend on the fellow’s career goals. Examples include participating or initiating a Quality Improvement Project or case report, participating in a clinical research project or developing educational materials. Each fellow will be assigned to a faculty mentor, and encouraged to prepare abstracts and submit work for publication in peer-reviewed journals and for presentations at local, regional and national meetings.

Fellows also receive travel support and time off to attend the Annual Assembly of the American Academy of Hospice and Palliative Medicine.

NYU Winthrop Hospital Hospice Palliative Medicine Fellows Core Lecture Topics 2019

Berger, Jeffrey T; Ribeiro Miller, Dana. ‘Corona and Community: The Entrenchment of Structural Bias in Planning for Pandemic Preparedness’ The American Journal of Bioethics. 2020

Berger, Jeffrey T; Hamric, Ann B; Epstein, Elizabeth. ‘Self-Inflicted Moral Distress: Opportunity for a Fuller Exercise of Professionalism’. The Journal of clinical ethics. 2019 30(4):314-317 (# 4252002)

Ribeiro Miller, D, Sumser, B, Stewart M., Spiritual, Religious, and Existential Dimensions of Care, Palliative Care: A Guide for Health Social Work, Oxford, NY, 2019.

Suanino DE, Brandeis GH. (2020). ‘Sites of Care for the Older Adult: Outpatient, Post-Discharge, Hospice’, in Chun, A (ed.) Geriatric Practice: A Competency Based Approach to Caring for Older Adults. Switzerland: Springer Nature, pp. 379-391.

Berger, Jeffrey T. Marginally Represented Patients and the Moral Authority of Surrogates. In press, American Journal of Bioethics.

Berger, Jeffrey T and Ribeiro Miller, D. “Being DNR”. Accepted for publication, Journal of Palliative Medicine.

Berger JT, Miller DR. Denial and Dyads: Patients Whose Surrogates and Physicians Are Unrealistically Optimistic. Am J Bioeth. 2018 Sep;18(9):29-31. doi: 0.1080/15265161.2018.1498939. PMID: 30235103

Vila-Castelar C, Ly JJ, Kaplan L, Van Dyk K, Berger JT, Macina LO, Stewart JL, Foldi NS. Attention Measures of Accuracy, Variability, and Fatigue Detect Early Response to Donepezil in Alzheimer’s Disease: A Randomized, Double-blind, Placebo-Controlled Pilot Trial. Arch Clin Neuropsychol. 2018 Apr 9. doi: 10.1093/arclin/acy032. PMID: 29635383

Berger JT, Ribeiro Miller D, Digangi Condon K. The Doctor-Patient-God Relationship: Doctor, Do You Believe in God? Is No “Simple Question”. American Academy of Hospice and Palliative Medicine Quarterly, 2018

Ribeiro Miller D, Sumser B, Stewart M, Spiritual, Religious, and Existential Dimensions of Care, Palliative Care: A Guide for Health Social Work, Oxford, NY, 2019.

Altilio T & Ribeiro D. Palliative Care, Oxford Research Encyclopedia of Social Work. Oxford, New York, 2018

Pinto, P, Brown, T, Khilkin, M, & Chuang, E. Patient Outcomes After Palliative Care Consultation Among Patients Undergoing Therapeutic Hypothermia. American Journal of Hospice and Palliative Medicine®, 35(4), 570-573. 2018

Pinto P, Carolyn Genereux and Elizabeth Chuang. “Intimate Partner Violence# 345.” Journal of Palliative Medicine 21.2 (2018): 255-256.

Moody K, McHugh M, Baker R, Cohen H, Pinto P, Deutsch S, Santizo RO, Schechter M, Fausto J, Joo P. Providing Pediatric Palliative Care Education Using Problem-Based Learning. J Palliat Med. 2018 Jan 21

Berger JT. The Limits of Surrogates’ Moral Authority and Physician Professionalism: Can the Paradigm of Palliative Sedation Be Instructive? Hastings Cent Rep. 2017 Jan;47(1):20-23. doi: 10.1002/hast.665. PMID: 28074584

Berger JT. Informed Consent is Inadequate and Shared Decision Making is Ineffective: Arguing for the Primacy of Authenticity in Decision Making Paradigms. In press, American Journal of Bioethics. 2017

Moody K, McHugh M, Baker R, Cohen H, Pinto P, Deutsch S, Santizo RO, Schechter M, Fausto J, Joo P. Providing Pediatric Palliative Care Education Using Problem-Based Learning. J Palliat Med. 2017 Aug 2

Pinto P, et al. “Patient Outcomes After Palliative Care Consultation Among Patients Undergoing Therapeutic Hypothermia.” American Journal of Hospice and Palliative Medicine® 35.4 (2018): 570-573.

Pinto P, Carolyn Genereux and Elizabeth Chuang. “Intimate Partner Violence# 345.” Journal of palliative medicine 21.2 (2018): 255-256.

Pinto P, Persaud D, Gritsenko K (2017) Sex and Gender in Pain. In: Yong R, Nguyen M, Nelson E, Urman R (eds) Pain Medicine. Springer, Cham. DOI 10.1007/978-3-319-43133-8_32

Altilio, T & Ribeiro, D. Palliative Care, Oxford Research Encyclopedia of Social Work. Oxford, New York.

Vila-Castelar C, Ly JJ, Kaplan L, Van Dyk K, Berger JT, Macina LO, Stewart JL, Foldi NS. Attention Measures of Accuracy, Variability, and Fatigue Detect Early Response to Donepezil in Alzheimer’s Disease: A Randomized, Double-blind, Placebo-Controlled Pilot Trial. Arch Clinical Neuropsychology. 2018 Apr 9.

Intensity of Vasopressor Therapy for Septic Shock and the Risk of In-Hospital Death. Brand DA¹, Patrick PA², Berger JT³, Ibrahim M⁴, Matela A⁴, Upadhyay S⁵, Spiegler P⁴. J Pain Symptom Manage. 2017 May;53(5):938-943. doi: 10.1016/j.jpainsymman.2016.12.333. Epub 2017 Jan 3.

Berger JT. The Limits of Surrogates’ Moral Authority and Physician Professionalism: Can the Paradigm of Palliative Sedation be Instructive? Hastings Center Report. January/February 2017 47 (1):20-23.

Van Arsdale A, Rosenbaum D, Kaur G, Pinto P, Kuo DY, Barrera R, Goldberg GL, Nevadunsky NS. Prevalence and factors associated with cognitive deficit in women with gynecologic malignancies. Gynecol Oncol. 2016 May;141(2):323-8. PMID: 26946094

Berger JT. Courage, Context, and Contemporary Health Care. Hastings Cent Rep. 2015, Nov-Dec;45(6):4. PMID: 26556137.

Berger JT. The Unfinished Business of Developing Standards for End-of-LifeCare: Leveraging Quality Improvement and Peer Review. Am J Bioeth. 2015;15(8):50-1. PMID: 26225521.

Berger JT. Stumbled, fumbled, bumbled, grumbled, and humbled: looking back at the future history of clinical ethics. J Clin Ethics. 2014 Summer;25(2):96-101. PMID: 24972059.

Presentations and Abstracts

Berger JT, Nabati L, Rotella J. Physician Assisted Dying: The AAHPM Ethics Committee Reports on its Work. American Academy of Hospice and Palliative Medicine Annual Meeting, March 10, 2016, Chicago, Il.

Ibrahim, M., Habtes, I., Upadhyay, S., Berger, J., Patrick, P., Brand, D., & Spiegler, P. (2014). Intensity of Vasopressor Therapy as a Predictor of In-Hospital Death In Patients With Septic Shock. Chest, 146(4_MeetingAbstracts), 229A-229A.

Berger JT. Ethics of Research with Noncapacitated Subjects. President’s Council Annual Conference. Cold Spring Harbor Laboratory. October 13, 2012.

Powell T, Berger JT, Swidler R, Lipman H. The Family Health Care Decisions Act. Panel Discussion. Metropolitan New York Ethics Network at the New York Academy of Medicine. NY NY June 20, 2011.

Berger JT. Ethics Harms and Guidelines for CPR. Paper presentation, Annual Meeting of the American Society for Bioethics and Humanities. Minneapolis, October 15, 2011.

McCauley R, Kelso C, Kreher M, Daly P, Berger JT. Is it Time to Pull the Plug on the Principle of Double Effect? American Academy of Hospice and Palliative Medicine. March 4, 2010, Boston, Massachusetts.

Lester PE, Berger JT. Atypical Chest Pain in a Geriatric Patient: Gastric Volvulus. Poster presentation, American Geriatric Society Annual Meeting, Washington D.C., May 12, 2008.

Berger JT, Khalil E, Khan S, Varghese T. The Reporting of Informed Consent and Related Issues in Critical Care Research. Paper presentation, Annual Meeting of the American Society for Bioethics and Humanities. Denver, CO., October 28, 2006.

Berger JT. Advance Planning and Treatment Preferences Among Recipients of Implantable Cardiac Defibrillators. Paper presentation, Annual Meeting of the American Society for Bioethics and Humanities. Washington D.C., October 22, 2005.

Berger JT, Majerovitz SD. Considering Family Burden in Surrogate Decisions Making for Research. Poster presentation, Gerontological Society of America Annual Meeting, Washington D.C., November, 19 – 22, 2004.

Berger JT. Patients’ Interests in their Family Members’ Well Being: An Overlooked Fundamental Consideration in Substituted Judgments. Paper presentation, Joint Meeting of the American Society for Bioethics and Humanities and the Canadian Bioethics Society, Montreal, Canada, October 26, 2003.

Berger JT. Integrated Institutional Ethics. Poster Presentation, American Society for Bioethics and Humanities, Annual Meeting, Philadelphia PA, October 28 – 31, 1999

Videos

Hospice and Palliative Fellowship Recruitment Video

Podcasts

Dr. Jeffrey Berger Annals Podcast – 07/01/2018 Issue

• CPR Survival Rates after Cardiac Arrest on Vasopressors
• Neuropsychological Correlates of Cancer Cachexia
• Efficacy of Topical Morphine for Painful Pressure Ulcers
• Impact of Interdisciplinary Pre-PEG evaluation on the use of PEGs
• Ethics of Surrogate Decision Making for Marginally Befriended Patients

NYU Winthrop Hospital’s graduate medical education programs create an atmosphere in which cultural and ethnic differences among patients, staff, and house staff are recognized, respected, understood and embraced. Residents participate in the care of a diverse group of patients and have the opportunity to work with colleagues from varied backgrounds. NYU Winthrop aims to bring the best residents, fellows and faculty from all ethnic, racial and gender groups to learn and care for patients in this diverse environment.

House Staff Benefits

Housing

Housing accommodations, are available at market rates in apartment buildings and residential homes within close proximity to the NYU Winthrop Hospital campus. Any house staff member may apply for the housing lottery. PGY 1 and PGY 2 residents receive priority.

Salary

Salaries are highly competitive with other academic medical centers in the New York metropolitan area. Tax deferred annuity is available. House Staff meal stipend will be included in the salary for the 2021-2022 academic year.

House Staff Lounge

NYU Winthrop Hospital’s new house staff lounge is accessible 24/7. The spacious and comfortable lounge is equipped with computers, wifi, television, foosball table, lockers, lounge chairs, as well as coffee and tea.

Vacation

NYU Winthrop Hospital residents and fellows receive four weeks of vacation (20 working days) within each contract year.

Educational Conferences

Residents are eligible for $1500 over the length of their program to attend an educational conference, at the discretion of the Program Director. Fellows are eligible for $1500 per year, to an approved professional conference, at the discretion of the Program Director.

Educational Allowance

Reimbursement for allowable educational expenses is available up to a maximum of $600.

TransitChek Commuter Benefit Program

The TransitChek Commuter Benefit Program is available. This program allows the resident/fellow to deduct pre-tax money to pay for mass transit or commuter parking (up to a predefined maximum).

Additional Benefits Include:

• Free parking while on duty
• Free prescription medications in the Hospital formulary for residents and at cost for eligible dependents
• Paid sick leave
• Free laundry service for lab coats and other hospital uniforms
• Health club membership discount at HealthTrax
• Graduation dinner gala

Insurance Benefits

Medical and Dental Coverage

NYU Winthrop Hospital is committed to providing residents with a comprehensive benefits program. Benefits include generous medical, pharmaceutical and dental coverage, as well as flexible spending accounts. Benefits are effective from the first day of residency/fellowship.

Disability Insurance

Residents/fellows are covered by short-term, non-occupational disability insurance (up to six months). To be eligible for disability insurance benefits, one must be on the payroll for a minimum of 20 work days (four consecutive weeks) and unable to work for more than seven calendar days, due an injury or illness that does not arise out of, or in the course of, employment. These benefits, which supplement lost income, are based on salary level and are payable for up to 26 weeks after the employee’s accrued sick time has been used.

The long-term disability benefit begins after six months of short term disability. It pays a monthly benefit for an extended illness or injury. The monthly benefit is offset by benefits from other sources, such as Workers Compensation and Social Security.

Workers Compensation

House staff receive compensation, in accordance with the Workers Compensation Law, for any illness or injury which is job related. Benefits include payment for medical expenses and lost pay.

Family and Medical Leave

In accordance with the Family and Medical Leave Act (FMLA) of 1993, NYU Winthrop Hospital will grant residents/fellows unpaid leave(s) for up to 12 weeks in a 12-month period. In order to be eligible, one must have worked 12 months at the Hospital and a minimum of 1,250 hours in the twelve-month period prior to the start date of the requested leave. FMLA leave may be granted for the birth, adoption or acceptance for foster care of a child; for the care of a child, spouse, or parent with a serious health condition; or for the employee’s own serious illness.

Residents/fellows may to return to their training program after a leave of absence, without loss of training status, if their leave does not exceed that allowed by the specialty boards.

Professional Liability Insurance

NYU Winthrop’s residents/fellows are provided with professional liability coverage for the duration of their training through the Hospital’s self-insurance program. Coverage provides legal defense and protection against awards from claims reported or filed after the completion of graduate medical education if the alleged acts are within the scope of the education program.

Life Insurance

Basic Life Insurance is provided by the hospital at no cost to the resident/fellow. This benefit equals 1x the resident/fellow’s annual salary payable to the beneficiary. Residents/fellows may purchase additional voluntary life insurance up to 3X their annual salary (combined basic and voluntary insurance may not exceed $500,000).

Accidental Death and Dismemberment Insurance

Provided by the hospital at no cost to the resident/fellow.

Retirement Plan

A Defined Contribution 403(b) Plan is available for voluntary pre-tax/after-tax contribution.

Occupational Health Services

NYU Winthrop Hospital residents and fellows are provided with pre-employment physicals, annual health assessments, and Tuberculosis screenings, as well as vaccines and required health surveillance free of charge through the hospital’s Occupational Health Services. In addition, if a member of the house staff becomes ill while at work, he or she will be seen at no charge by an Occupational Health Services practitioner, or by the Emergency Room staff if a practitioner is not available.

Counseling Services

Free assessment, referral and brief psychotherapy services are available on a confidential basis to members of the House Staff and their immediate families.

Employee Assistance Program

This free, confidential, crisis-response resource is available 24/7 to residents, fellows and their family members to assist with the following concerns –

• Psychological
• Child and elder care
• Daily living
• Legal/financial
• Work-related concerns

The longest and largest island in the contiguous United States, Long Island stretches over 100 miles from New York City to Montauk Point. A celebrated summer vacation spot, Long Island offers seasonal beauty, professional sports events, art museums and galleries, and fabulous cuisine. Eastern Long Island has gained fame as for its vineyards, and is home to almost 20 wineries. From NYU Winthrop it is a short trip to Manhattan, where you can enjoy world class dining, museums, and endless cultural opportunities. From scenic Atlantic Ocean beaches to Fire Island, the Hamptons and Montauk Point, Long Island has something for everyone.

Convenient access to NY City is available by Long Island Railroad located directly adjacent to NYU Winthrop Hospital. Residents and fellows take advantage of the opportunity enjoy the myriad of cultural, social, and professional activities in New York City. Additionally, NYU Winthrop’s location in central Nassau County allows easy access to spectacular beaches.

The village of Mineola is a wonderful place to live and work. Mineola affords one the opportunity to enjoy the relaxed Long Island lifestyle, while living only 30 minutes away (via LIRR) from the attractions of NYC.

The close vicinity of the hospital, where most of the resident housing is located, is an excellent location for both families and single residents. Aside from a LIRR station leading directly into NYC, the area is surrounded by a quiet residential neighborhood and a large park with sports facilities, open fields, and a local library. The Roosevelt field mall, one of the largest retail centers on Long Island, is located less than a mile away from the hospital along with a large conglomerate of brand name stores and services.

You can also enjoy the wonderful things that Long Island itself has to offer You will find that living in Mineola is a sound choice from the economic perspective. While residents living in large cities incur significant living expenses, Mineola is very affordable.

Useful Links

Application FAQ

What are the program requirements?

Prerequisite Training: Completion of an ACGME-accredited residency program.

Required documents include:

• Common Application Form (CAF)
• Curriculum Vitae
• Personal Statement
• Medical School Transcript
• USMLE scores or COMLEX scores (Step 1, Step 2 CK, Step 2 CS/PE, and Step 3)
• ECFMG (if applicable)
• Three letters of recommendation

When are applications due?

ERAS opens in mid-July and continues to accept applications until our program fills all of our positions for the following year. The Hospice and Palliative Medicine Fellowship program is now participating in the NRMP Match. Therefore, it is highly encouraged that all applicants apply prior to the Match deadline which is typically in early November.

Do you sponsor J1 visas? Yes.

Do you sponsor H1B1 Visas? No.

Do you accept foreign medical graduates? Yes.

Is this an accredited program? Yes.

Does your program participate in the Match process? Yes.

Do you provide housing? NYU Winthrop is known for its heavily discounted housing for house staff. Both apartments and houses for fellows with families are located steps from the NYU Winthrop Hospital campus. If a member of the house staff requests NYU Winthrop housing and it cannot be provided, a live-off allowance may be provided.

Do you cover educational expenses and conferences? House staff at the PGY-2 level and above are eligible for one trip, (maximum of five consecutive weekdays), to an approved professional conference in the continental United States each year, at the discretion of the Program Director. Reimbursement for allowable educational expenses is available up to a maximum of $75 for PGY-1 residents and $700 for PGY2 and higher residents and subspecialty fellows.

For further questions, contact us:

Melissa Mooney
Academic Coordinator, Hospice and Palliative Medicine Fellowship
NYU Winthrop Hospital
Division of Palliative Medicine and Bioethics
222 Station Plaza North
Suite 605
Mineola, NY 11501
Tel: 516-663-4680
Fax: 516-663-2989
Email Melissa

Student Rotations

1. U.S. Medical students
2. International Medical students
3. Podiatry Students

Resident and fellow Rotations

Residents and fellows can apply for a rotation with any department by contacting the academic coordinator for that program via email with a copy of your CV and the dates you are requesting for your rotation.

The department will review your CV and let you know if there are any rotation spots available for the time requested. If you are approved for the rotation the Office of Academic Affairs will contact you with the necessary paperwork.