UMMS ramps up palliative care training partnership with Brazil

A new training partnership is bringing Brazilian doctors to UMMS to learn about end-of-life care.

Dr. Marcos Montagnini (left) and recent visiting Resident Lucas Furtado, the latest University of Sao Paulo resident to visit UMMS to learn more about end-of-life care.

The Department of Internal Medicine at the University of Sao Paulo (USP) and the UMMS Division of Geriatric Palliative Medicine launched collaborations in 2016, bringing residents from Brazil to spend one month at Michigan Medicine to learn basic concepts of palliative medicine. Six USP residents have taken advantage of the new program, said UMMS Professor of Internal Medicine and Director of the Hospice and Palliative Medicine Fellowship Program Marcos Montagnini.

“Hospice care is almost non-existent in Brazil, and palliative care is really an emerging field there. As director of the palliative care fellowship programs at UMMS, there was an opportunity for me to get actively involved,” said Montagnini, MD, a native of Brazil who did some of his residency training at USP.

Montagnini and his colleagues leveraged an ongoing institutional partnership between UMMS and USP to tailor and implement their palliative care program for visiting USP residents. The in-depth clinical observational experience includes time at the Ann Arbor VA, Michigan Medicine and Arbor Hospice. The residents follow the palliative care teams at each site and have the opportunity to observe interactions with patients and families. They interact closely with the hospice and palliative medicine fellows and the attending physicians, and also participate in a weekly VA palliative care outpatient clinic.

In addition the initial six residents hosted by UMMS in 2016, three more are expected in 2017 including one set to arrive in May. The visiting residents learn about end-of-life pain management and gain communication skills pertaining to delicate end-of-life situations, abilities that will help make them better doctors back home. In contrast to the United States, palliative medicine instruction is not a requirement in Brazilian medical schools, and very few schools offer any related instruction. Palliative medicine instruction at the post-graduate level is also insufficient, a fact that Montagnini hopes this new partnership will help change.

“Our long-term goal would be to help them create a faculty development program to train their own students in palliative care,” he said. “And also to develop joint research projects – exploring both medical education programs and clinical research – in collaboration with USP in this area.”

In the meantime, the program is already meeting patient needs on an individual basis with the visiting residents returning to Brazil with new perspectives and skills. Dr. Montagnini is among scheduled speakers at the upcoming April 25 Global Health Initiatives Forum meeting, where he is set to present the program’s early successes.

“We are already seeing an impact for our visitors from USP who are returning to Brazil and actively engaging in patients and families in palliative care discussions,” Montagnini said. “Considering the effort is so new, I’m very pleased with impact the partnership is already having.”