AMSA End of Life Fellowship :

1. AMSA End of Life Fellowship: How Can I Implement This at My School? Tasha Zaman MSII Midwestern University- Arizona College of Osteopathic Medicine

2. What We Currently Have in Place • 1st and 2nd Year, End of Life Elective -Advanced Directives -Moyer Series -Legal and Ethical Issues -One Shift with a Hospice Worker -Pain Management and Dosing -Communicating Bad News -Symptoms at the End of Life *Problem: Small number of med students elect to take this course -

3. Currently in Place Cont. • 2nd Year, Pharmacology - One Lecture on Pain Medications *Problem: Does not include pain management and dosing • 3rd and 4th year Didactics -One Lecture on Grief and Bereavement -One Lecture on Communicating Bad News *Problem: No role plays done -One Lecture on Pain Medicine Addiction Given by Addiction Medicine Physician *Problem: Deciphers between drug seeker and patient with pain, but does not emphasize importance of pain management and statistics of addiction

4. What Can Be Implemented • 1st Years -Preceptor Program: During last quarter have small groups shadow Hospice Physician for an afternoon

5. 1st Year Cont. -ICM or Topics Course: Show “Wit” w/ Discussion *can offer extra credit *use opportunity to promote E of L elective and lunch time lecture series

6. End of Life Elective -Continue course, yet stress importance -Share my experience with course coordinator for any updates What Can Be Implemented Cont.

7. End of Life Week • Lunch Time Lectures *in collaboration with AMSA, Spirituality in Medicine Club, and Integrative Medicine Club Mon: Picturing Your Own Death and the What is Hospice? How do these questions relate? Tues: View “To Live Until I Die” Wed: Legal and Ethical Issues in E of L Care *includes Advanced Directives, Physician-Assisted Suicide, Withdrawing/Withholding, Nutrition and Hydration

8. End of Life Week Thurs: Spiritual Care of Patient- Various Cultural Views on Death Fri: CAM in End of Life and Self-Care • Both the elective and lecture series targets 1st and 2nd Year students

9. Back to the 1st Years • Intro to Clinical Medicine -Lecture on Common Physical Symptoms at E of L • Human Behavior -Lecture on Grief and Bereavement, including differences of grief and major depression

10. AMSA Regional Conference • Hosted in Phoenix, AZ on Oct. 28-30 • Over 300 students attending • Over 20 medical schools represented • 7 different states • Pre-medical students and medical students • Include lectures/programming on Bioethics

11. 2nd Years • Clinical Class -Lecture on Communication of Bad News • SPEs -add role play -give scenario of communicating bad news -tape students • Communication Workshop -to help prepare for the SPEs, allow practice time, and give pointers

12. 3rd and 4th Year • Rotations -Accept Hospice Physicians as Internal Medicine Rotations -Make them Accessible! Include them in the lottery.

13. 3rd and 4th Year Cont. • Didactics -Hospice Dr. to Lecture on Hospice/Palliative Care and Its History and have a Pt w/ terminal illness in Hospice -Lecture on Pain Meds w/ Dosing Given by Hospice/Palliative Care Physician -Lecture on Advanced Directives and Role Play for Pt visits -Lecture on Cultural & Spiritual Views of Death

14. The Goal is: • To have continuous end of life education, without being redundant. • To have continuous end of life education, without being redundant. • To have continuous end of life education, without being redundant. • To have continuous end of life education, without being redundant.