The University of Mississippi Medical Center’s Division of Pediatric Palliative Care recently became one of only 10 programs nationwide offering an accredited pediatric-dedicated fellowship in hospice and palliative medicine and will graduate its first fellow in July.
After completing his fellowship next month, Christian Paine, M.D. will be eligible for certification by the American Board of Pediatrics in Hospice and Palliative Medicine.
Because completing a fellowship is the only pathway to board certification in this discipline, Dr. Rick Boyte, professor and chief of pediatric palliative care, believes getting the accreditation lends the pediatric palliative care program credibility.
“There are many children’s hospitals out there with palliative care services doing a great job taking care of patients, but I think having a fellowship shows an additional commitment and level of expertise,” Boyte said. “I’m very proud of the fact that we’re one of the few because I think it shows a commitment to expanding, to growing, but especially to maintaining the level of expertise.”
There are currently only nine other institutions in the country with pediatric-dedicated accredited fellowship programs, making Paine one of only 14 potential graduates to enter the medical work force with this level of training and expertise.
Fellowships concentrated on adult palliative care are far more prevalent, with 96 institutions offering accredited training programs with 223 slots.
Boyte is hopeful the one-year fellowship will help grow the pediatric palliative care program by encouraging pediatric residents to come to UMMC for the one-year fellowship and then stay and join the staff, much like Paine, who becomes an attending physician with the program in July.
An Ole Miss graduate, Paine received his M.D. from the University of Mississippi School of Medicine.
Knowing he wanted to treat children with very complex diseases, Paine says he has “always had a heart for the underdog,” but went through medical school and much of his residency without feeling like he had found a place where he fit.
During his pediatrics residency at UMMC, he discovered pediatric palliative care, which he calls his “niche.”
Dr. Christian Paine, left, confers with Dr. Rick Boyte, chief of pediatric palliative care.
“I was able to do the work, I just couldn’t find the thing that I loved and then I just remember enjoying every time I was able to spend on the palliative care service,” Paine said. “Just getting to know Dr. Boyte and the team that he built, it felt a little like coming home. It was a group of people that I really enjoyed being around and felt like a kindred spirit with.”
Palliative care began as an outgrowth of hospice care and was first recognized by the American Board of Medical Subspecialties in 2006. Unlike hospice care, palliative care begins at diagnosis and is administered concurrently with curative care and regardless of whether the result is death or cure.
When Boyte began the pediatric palliative care service at Batson Children’s Hospital in 2009, the team saw patients on a consult-only basis.
In the last five years, the program has experienced tremendous growth, now following about 150 patients a year and developing its own inpatient and outpatient service. The outpatient service includes help for families with children who depend on a ventilator and perinatal and bereavement counseling. Boyte hopes to “beef up” support for pediatric oncology patients and pain management as well.
Boyte said the fellowship was always a possibility down the road, but he doesn’t believe he would’ve had the incentive to start it as soon as he did had it not been for Paine’s interest. He also got a good deal of encouragement from national leaders in pediatric palliative care because of the shortage of practitioners.
The fellowship is one of only four offered in pediatrics at UMMC, with others in pediatric intensive care, neonatal intensive care and hematology-oncology. The Accreditation Council for Graduate Medical Education offers the certification and is the only organization of its kind that evaluates residency and fellowship programs throughout the United States.
“I wish I could say back in 2009 that I had this vision that this is where we’re going to go, but really we’re following where the needs are,” Boyte said. “It just kept expanding.”