Palliative Care
Second year Residents have a choice of two excellent block Palliative Care Rotations at William Osler Health Centre:
Dr. Vincent Maida offers an experience in the palliative management of patients with “advanced illness”. The palliative medicine program based at the Etobicoke General Hospital combines community and hospital care in a seamless fashion. The palliative program is supported by an interdisciplinary team that includes nurses, pharmacists, chaplain, social worker, PT/OT, and dietician. The model of care is one of “escalating consultative support”. The in-patient program consists of a 16 bed unit. Dr. Maida conducts palliative medical consultations in both the community and throughout the hospital, in addition to providing a consultative service for chronic pain (malignant and non-malignant) and wound management. In addition, he runs a wound out-patient clinic one morning per week. This rotation will afford the resident an opportunity to obtain proficiency in counselling patients and families in transitioning from acute care to palliative care, as well as developing proficiency in pain and symptom management, prognostication, and procedures such as paracentesis, thorocentesis, and wound debridement. Dr. Maida also has developed a lecture series on a number of core topics in palliative medicine that will be available to provide a basis for the resident’s clinical experience. Dr. Maida also welcomes potential resident involvement in clinical research and manuscript reviews. 
Dr. Sandy Sehdev; Director of Education for the oncology group and Amanda Maclennan Palliative Care Nurse Clinician offer a Palliative Care block selective at Brampton Civic Hospital. The resident will be involved in both inpatient and outpatient consultations under the supervision of 2-3 oncologists and home visits with the nurse. There is a 25 bed palliative unit and about ¼-1/3 of the patients have non-malignant diagnoses; such as CHF, COPD, dementia, or acute complex medical illnesses at the end of life. This unit has patients who attend for short stay, end-of-life and respite care. The patients are 18 years of age or older. Amanda does some pediatric palliative care in the community. The resident will be involved with the Interprofessional team which includes the Nurse Educator, OT, PT, speech therapist, dietician, recreational therapists, bereavement social worker and pharmacist. The resident is invited to attend oncology education rounds that occur every 2 weeks, which include our community partners (CCAC, Hospice of Peel, RNs).
There will be opportunity to learn about the practical aspects of delivering effective palliation, such as:
-managing effective, evidence based pharmacotherapy of pain and terminal symptoms
-administrative aspects of setting up a program and working with community partners
-visiting our regional radiation centre in Mississauga to see radiation delivered for palliative indications
-effectively transitioning aticlients from active care to palliation, recognizing the overlap between the two
-discussing DNR and end of life planning with patients and families