About Our Program

The Hospice & Palliative Medicine Fellowship is a combined training program between Bluegrass Care Navigators and the University of Kentucky College of Medicine. It is a 1-year ACGME accredited program dedicated to developing compassionate, competent, and collaboratively minded physician leaders and educators who will go on to provide quality care for seriously ill patients in a variety of inpatient and community settings. Currently our program trains 1 fellow each academic year. Starting academic year 2021-2022 we will be accepting 2 physicians into our program.

Fellows receive well-rounded training through clinical experiences, didactics, workshops, and conferences to acquire expert skills in symptom management and communication.

Partnering Organizations

Bluegrass Care Navigators (BCN), previously Hospice of the Bluegrass, is a national leader in delivering high quality end-of-life care and a pioneer in developing new programs that are responsive to the evolving needs of seriously ill patients and their families. In addition to providing hospice services, BCN operates Bluegrass Palliative Care, Bluegrass Home Primary Care, Bluegrass Adult Day Health Care, Bluegrass Extra Care, Bluegrass Transitional Care and Bluegrass Grief Care.

BCN is a designated Palliative Care Leadership Center (PCLC) through the Center to Advance Palliative Care. As one of eight PCLCs in the United States, BCN has trained over 300 organizations in establishing and expanding high-quality palliative care programs. Finally, BCN is a two-time recipient of the prestigious “Circle of Life” award through the American Hospital Association and has been named a “Best Places to Work” by Modern Health Care for multiple years.

The UK Inpatient Palliative Care consult service provides trainees with in-depth experience with the full spectrum of patients, problems, and consultant relationships that Palliative Medicine Physicians are likely to encounter. In addition to the attending physician our interdisciplinary team includes a Triage Nurse, Advanced Nurse Practitioners, and a full time Chaplain, Licensed Clinical Social Worker and Pharmacist. This breadth provides deep learning opportunities. Learners of all levels rotate with the team allowing fellows to expand their teaching skills. We add an extra layer of support to every team at UK Chandler Medical Center including Advance Heart Failure and LVAD, Cardiac Critical Care and ECMO, Inpatient Oncology and Bone Marrow Transplant, all Critical Care and Surgical Specialties just to name a few. 

Participating Institutions 
        
St. Joseph Hospital Baptist Health Lexington UK/Kentucky Children's Hospital

 

 

Schedule

Core Rotations

  • 5 months- Adult Inpatient Palliative Care Consult Service
  • 1 month – Pediatric Palliative Care Consult Service (inpatient and outpatient)
  • 1 month – Long Term Care
  • 1.5 months – Home Hospice
  • 2 months – Inpatient Hospice
  • 1.5 months – Elective Rotations
  • 1 day/week continuity clinic throughout the year 

 

Clinical Experiences

Inpatient Palliative Care – During the 5 months of this experience the fellow works as a member of an interdisciplinary team providing inpatient palliative care consultation to patients with a variety of serious illnesses. The rotations are comprised of 3 months at University of Kentucky Albert B. Chandler Hospital and 2 months at St. Joseph Hospital. As such, fellow will gain experience in both the academic and community hospital settings.

Continuity Clinic – The continuity clinic experience is embedded in Baptist Health Lexington’s outpatient oncology center. One day each week throughout the year will be spent providing palliative care consultation, in coordination with interdisciplinary team members, to patients who require advanced symptom management, advance care planning, and goals of care conversations.

Long Term Care – 2 weeks in the Fall and 2 weeks in the Spring will be spent providing palliative care consultation to patients in the long-term care setting. Bluegrass Palliative Care provides specialty palliative care to more than 16 facilities in Fayette County. This care is largely provided in coordination with APRNs. Other long-term care experiences will be encountered on the home hospice rotation as well.

Home Hospice – Bluegrass Hospice Care provides end of life care to patients in 32 counties across Kentucky. The fellow’s exposure will be limited to patients in Central Kentucky. The fellow will go on home visits with various faculty, and toward the end of the academic year will do home visits independently.

Pediatric Palliative Care – The fellow rotates with the Pediatric Advance Care Team at Kentucky Children’s Hospital, both in the inpatient and outpatient settings. During this month long rotation, the fellow will gain the knowledge and experience with prognostication and communication as it relates to the seriously ill pediatric population.

Electives – Previous fellows have chosen from a variety of electives. These include, but are not limited to: Radiation Oncology, Addiction Medicine, Interventional Pain, VA Hospice & Palliative Care, and additional time in Pediatric Palliative care. The electives are evaluated annually and continue to be adjusted as needed to maximize the experience of the fellow.

Curriculum

Educational Lecture Series – Weekly lectures are held throughout the academic year. The location and topic vary to ensure information is most relevant and least disruptive to the fellow’s current rotation and location. The lecture series incorporates speakers from various specialties providing the most up to date evidence-based information.

Wellness - Throughout the year the fellow will have opportunities to attend Schwartz Rounds at Chandler Medical Center, journaling workshops, and one-on-one narrative medicine sessions. Each year the fellow is also matched with someone for mentored wellness check-ins. These check-ins are built into the schedule, and the format is left up to the mentor and fellow. 'Mindfulness Moments’ is a weekly session led by BCN’s clinical psychologist, and the fellow is encouraged to attend these sessions regularly.

Addiction Medicine – Our program continues to strengthen relations and involvement with Addiction Medicine at UK, as we are seeing more crossover in our seriously ill patients with substance use disorders. Managing Addiction, Pain, and Palliation Interdisciplinary Team (MAPPIT) meets monthly for journal article and case presentations. Specialists in pain management, addiction, and palliative care from across the state participate in these meetings, and the HPM fellow is highly involved as well.

Ethics – The fellow is required to attend 3 Ethics meetings throughout the year. Additionally, the fellow attends the state bioethics conference, KYHEC.

Communication Skills Training – Providing a structured training experience in communication skills for HPM fellows is essential, and we continue to prioritize it throughout the year. One of our very own faculty, Dr. Jessica McFarlin, is also VitalTalk faculty. There are various opportunities throughout the year to attend a 1-day VitalTalk training, and the fellows have previously participated in the VitalTalk pre-conference at the AAHPM Annual Assembly. We are working on something exciting for our fellows for the future! Stay tuned.

Hospice Medical Director – Providing the fellow with the skills necessary to become a Hospice Medical Director is a core objective for our program. As such, the fellow will spend the first half of the year participating in Interdisciplinary Team Meetings for a designated home team and will be leading those meetings as the HMD for the second half of the year. Our fellow also participates in Bluegrass Hospice physician triage days throughout the year to gain a better understanding of the administrative and clinical duties, as well as regulatory information, required of an HMD. By the end of the year the fellow should be well poised to complete the Hospice Medical Director Certification Exam, should he/she choose to take it.

Guided Self Study – Along with the fellow’s yearly rotation schedule we provide recommended resources and a structured approach to self-study throughout the year. The resources match the rotation in which the fellow is currently rotating (ex. Hospice Medical Director Manual while on home hospice rotation). The fellow is provided with access to CAPC modules, AAHPM online resources, VitalTalk online modules, and more.

Scholarly Activities

Grand Rounds Presentation – The fellow gives a lecture on desired HPM topic at the University of Kentucky Chandler Internal Medicine Grand Rounds.

Quality Improvement Project – In coordination with a designated faculty member the fellow will participate in and complete a quality improvement project of their choice. At the end of the year the fellow will give a presentation of their project to UK and BCN.

Professional Conferences – The program sends the fellow to multiple professional conference, including the AAHPM Annual Assembly, the annual state conference KAHPC, and the annual state bioethics conference KYHEC.

 

Meet the Faculty

 

Marguerite Mueller, MD, FAAPMR

Palliative Care Physician, Bluegrass Care Navigators
Residency: Physical Medicine & Rehabilitation,
Board Certified in Hospice and Palliative Medicine

 

 

 

 

 

 

Todd R. Cote, MD, HMDC, FAAFP, FFAHPM

CMO, Bluegrass Care Navigators
Residency: Family Medicine
Board Certified in Hospice and Palliative Medicine

 

 

 

 

 

 

 

Jessica McFarlin, MD

Division Chief, Palliative & Supportive Care at University of Kentucky
Residency: Neurology,
Board Certified in Hospice and Palliative Medicine

 

 

 

 

 

 

 

Salli Whisman, MD

Senior Medical Director, Bluegrass Hospice Care
Residency: Family Medicine
Board Certified in Hospice and Palliative Medicine

 

 

 

 

 

 

 

Katrina Nickels, MD

Outpatient Palliative Care Physician, Bluegrass Palliative Care
Residency: Internal Medicine
Board Certified in Hospice and Palliative Medicine

 

 

 

 

 

 

 

 

Cecil Peppiatt, MD

Palliative Care Physician, University of Kentucky
Residency: Internal Medicine
Board Certified in Hospice and Palliative Medicine

 

 

 

 

 

 

 

Lindsay Ragsdale, MD

Director, Pediatric Advanced Care Team
Division Chief, Pediatric Palliative Care at University of Kentucky
Residency: Pediatrics
Board Certified in Hospice and Palliative Medicine

 

 

 

 

 

 


Kimberly Bell, MD

Hospice Team Physician, Bluegrass Hospice Care
Residency: Internal Medicine
Board Certified in Hospice and Palliative Medicine

 

 

 

 

 

 

 

 

Current Fellow

Jeffery Dedelow, MD

2020-2021
Medical School: Indiana University School of Medicine
Residency: Radiology-Diagnostic, Ochsner Clinics Foundation/Ochsner Health Systems


Former Fellows

2019-2020

Pete Wallenhorst, MD

Residency: Internal Medicine, University of Kentucky
Current Practice: HPM physician and hospitalist at the VAMC in Lexington, KY

2018-2019

David Flemig, MD

Residency: Internal Medicine & Pediatrics, University of Kentucky
Current Practice: HPM physician at University of Colorado in Denver.

2017-2018

Elizabeth Markus, MD

Residency: Internal Medicine, University of Kentucky
Current Practice: HPM physician at the VAMC in Lexington, KY

2016-2017

Terri Walling, MD

Residency: Internal Medicine, West Virginia University
Current Practice: HPM physician at Bluegrass Care Navigators

 2015-2016

Robert Learch, DO

Residency: Internal Medicine, University of Kentucky
Current Practice: primary care physician at Baptist Health in Paducah, KY

2014-2015

Hyeong Kim, MD

Residency: Internal Medicine, Advocate Lutheran General Hospital
Fellowship: Pulmonary & Critical Care Medicine, University of Kentucky
Current Practice: Pulmonary & Critical Care at University of Maryland in Baltimore

2014-2015

Vernon Brewer, DO

Residency: Family Medicine, University of Texas Health System
Current Practice: HPM physician at Bluegrass Care Navigators

2013-2014

Bethany Snider, MD

Residency: Internal Medicine, University of Kentucky
Current Practice: CMO of Hosparus in Louisville, KY

2012-2013

Jenni Skorupa, MD

Residency: Family Medicine, East Tennessee State University
Current Practice: HPM and primary care physician for home based primary care with Bluegrass Care Navigators

 

How to Get Here

Bluegrass Care Navigators
1733 Harrodsburg Road
Lexington, KY 40504


https://bluegrassairport.com/

 

  

What To Do in Lexington, KY

Keeneland Racetrack

https://www.keeneland.com/

 

 

 

 

 

Kentucky Horse Park 

https://kyhorsepark.com/

 

 

 

 

Bourbon Trail

www.kybourbontrail.com

 

 

 

 

Lexington Distillery District 

https://www.lexingtondistillerydistrict.com

 

 

 

 

Rupp Arena

https://www.rupparena.com/

 

  

 

 

 How to Apply


Interested residents may apply through the Electronic Residency Application Service (ERAS), and the Fellowship applicant will be chosen through the National Resident Matching Program (aka The Match). The Match typically opens in July each year, and Match Day is typically early December. For more information about the application, please contact ERAS and NRMP.

Applicants must have completed an ACGME or AOA accredited residency program in Internal Medicine, Family Medicine, Neurology, PM&R, Psychiatry, Surgery, Pediatrics, Anesthesiology, or Radiation Oncology.

 
Contact Us

Natalie Houghton, DO, HMDC

Hospice Team Physician
Hospice and Palliative Medicine Fellowship Program Director
nhoughton@bgcarenav.org

Lizzie Eubank

Executive Director, Palliative Care
Hospice and Palliative Medicine Fellowship Coordinator
leubank@bgcarenav.org
859.296.6298

 

Interviews

*Due to COVID-19 restrictions, all interviews for academic year 2021-2022 will be completed virtually
Applicants flying into Lexington will fly into Blue Grass Airport. Our program will provide overnight accommodations at…. Lunch and transportation throughout the interview day will be provided by the program as well. The interview day includes meeting with the program coordinator, program director, the current HPM fellow, and members of our interview committee. Applicants will tour the University of Kentucky Albert B. Chandler Medical Center and the inpatient hospice units at both St. Joseph’s Hospital and UK.

Meet the Program Director

Natalie Houghton, DO

Residency: Internal Medicine, Roger Williams Medical Center/Boston University Medical School
Fellowship: Hospice & Palliative Medicine, University of Pennsylvania