Clinical Ethics Fellowship

Value Statement

University Hospital in San Antonio, Texas is offering to a year-long fellowship to a qualified applicant in clinical bioethics under the supervision of the Director of Ethics. The need for highly skilled clinical ethicists in healthcare means University Hospital, as a teaching institution, embraces a clinical ethics training approach that is comprehensive and grounded in objective tools. To this end, University Hospital adheres to the core competencies promoted by the American Society for Bioethics and Humanities (ASBH). These competencies are what the successful candidate will develop and hone to an advanced level of skill.[1]

ASBH Core Competencies in Clinical Ethics Consultations

The subspecialties that underpin a successful clinical ethics consultation service are the elements this fellowship program makes available during this one-year fellowship position:

  • Clinical Ethics
  • Organizational Ethics
  • Business ethics/Professional Ethics
  • Education Ethics
  • Research Ethics

The fellow, under supervision, will learn or enhance existing clinical skills of dealing with patients, families, physicians, medical staff and ancillary professional medical employees of University Hospital that eventually will lead to a proficient advanced level of professional conduct in clinical ethics consultation.

[1]“Health Care Ethics Consultation: An Update on Core Competencies and Emerging Standards from the American Society for Bioethics and Humanities’ Core Competencies Update Task Force”, by Anita J. Tarzian. Published in The American Journal of Bioethics, 13(2): 3-13, 2013. See also

About University Hospital

University Health System is a nationally recognized teaching hospital and network of outpatient healthcare centers, owned by the people of Bexar County. U.S. News & World Report has ranked it consistently as the best hospital in San Antonio, sixth-best in Texas and among the top 50 in the nation in the care of patients with kidney disease. University Health System is committed to delivering patient-centered, culturally competent and high-quality healthcare for adults and children based on a strong foundation of outcomes‐based research and innovative teaching. University Hospital is the premier Level I trauma center for South Texas, and the Health System is the region’s only healthcare organization to earn Magnet designation – the Gold Standard in patient care – from the American Nurses Association.

What to Expect

This program provides the fellow with access to The University of Texas Health Science Center at San Antonio, specifically the Center for Medical Humanities and Ethics (The Center) as a resource throughout the program to enhance the clinical ethics component of the fellowship. The following areas identify expectations the fellowship program has for the successful candidate, the educational opportunities available from both University Hospital and The Center, and finally the requirements to be met for the fellow to successfully complete this clinical ethics fellowship.

Structure of this Program (Components)

  • Seventy-Five percent (75%) of the fellow’s time is spent in the pursuit of developing and honing clinical ethics
    consultation skills
  • Twenty-Five percent (25%) of the fellow’s time is spent on the research ethics component, which supports the fellow’s need to write a paper for peer review submission and an Abstract for acceptance at a conference or workshop, with the goal of making a presentation based on the Abstract

Assessment of the Fellows’ Skills and Knowledge

  • At three designated points in the fellowship, the Integrated Ethics document, “Ethics Consultant Proficiency
    Assessment Tool” will be self-administered and discussed thoroughly with the Director of Ethics
  • A feedback loop with ancillary staff and medical staff will occur at intervals of 3 months, 6 months and 11 months
  • Teaching at least one seminar or class at The Center and assessment of the experience
  • Presentation at least once at Grand Rounds
  • Weekly meetings with the Director of Ethics
  • Beginning statement of philosophy regarding health care ethics, submitted to the Director of Ethics within the first month of the fellowship and an Exit statement of philosophy regarding health care ethics, submitted the last month of the fellowship

Service Expectations

  • The fellow will initially take part in an Orientation that introduces the hospital layout and the aspects of daily and weekly interaction with both University Hospital and The Center. This period of time requires of the fellow:
    • Familiarity with the structure of both facilities
    • Review of all hospital policies related to Ethics, available on the hospital’s Intranet
    • Familiarity with the Department of Ethics’ electronic Ethics Library, available on the department’s webpage
    • Introductory meeting with The Center’s Director and faculty
    • Shadowing specific ancillary staff at University Hospital

The remaining period of the fellowship’s first six months will reflect continuing responsibility for the above-stated elements of the orientation period, along with the following service expectations:

  • Clinical Responsibilities
    • Daily supervision with the Director of Ethics and when appropriate, with the Assistant Director of Ethics, Nursing
    • Attendance at ethics/interdisciplinary rounds in the acute care setting
    • Participation in clinical ethics consultations with debriefing sessions
    • Ethics Committee membership and participation at University Hospital
    • Development/Review of hospital policies, especially as the policies impact the Ethics Committee
    • Attendance at Grand Rounds
    • At least once during this fellowship, presents at the Grand Rounds
    • Every two weeks, submits to the Director of Ethics a summary of activities, including an ongoing portfolio of the case consultations the fellow has participated in, with comments about the experience
    • Assists faculty of The Center in ways that will be ascertained during the Orientation period

Educational Opportunities

  • Throughout the twelve-month period, the fellow will experience the following;
    • Educational programs offered to the Ethics Committee(s)
    • Mentoring from the Director of Ethics, the Assistant Director of Ethics, Nursing and faculty at The Center
    • Educational presentations offered through The Center
    • Clinical Rounds with physicians and other medical staff and ancillary staff
    • Teaching in the second six-month period of the fellowship
    • Conducting at least two family conferences
    • Ethics in-services
    • Availability of selected classes or seminars at The Center
    • Time to conduct research ethics reviews in general and
      • Specifically for a peer-review prepared paper to be submitted in the last two months of the fellowship program
    • On-call rotation with supervision during the second six-month period of the fellowship, including weekend coverage
    • Maintenance of the Ethics departments’ electronic continuing education library on both clinical ethics and organizational ethics issues
    • Opportunity to observe Ethics Committees in area hospitals of San Antonio
    • Participates in the Greater San Antonio Ethics Forum group

Program Requirements (Successful completion)

  • Presentation of a clinical ethics case study to the University Health System Ethics Committee during the second six month period of the fellowship
  • Participation in conferences and workshops offered in the field of clinical ethics
    • Submission of an Abstract to at least one conference/workshop with the goal of making a presentation on the submitted topic
  • Continual and consistent maintenance and contribution to the electronic library of the Ethics Department, which is available to all medical staff on the University Health System Intranet
  • Continual and consistent work with the University Health System hospital policies, updating and creating necessary policies under supervision
  • Completion of a peer review ready manuscript on a topic current to the areas of clinical and organizational ethics, to be submitted for peer review in the last two months of the fellowship program
  • Submission of fellowship activity every two weeks to the Director of Ethics

Who should apply

  • Those applicants with a completed graduate degree in Health Care Ethics
  • Those applicants with a terminal degree (Ph.D., J.D.) in Bioethics or a related field, with focus on health care and clinical/organizational ethics
  • Those applicants with extensive clinical experience in acute or long-term health care and a graduate degree
  • Those applicants with a Certificate of Bioethics and completed undergraduate degree will be considered in the context of the applicant pool

Application Process

  • The application is to be completed on the University Health System Human Resources website from January 1, 2016 through March 30. 2016. Fellowship dates are August 1, 2016 through July 31, 2017.
  • In addition to the online application:
    • The applicant is to submit a narrative statement that addresses
      • Their learning expectations
      • Career goals
      • Why University Health System?
      • Past clinical experiences

Please send this narrative statement to: and identify your name and the date you completed and submitted your online application to Human Resources.

Note: The stipend for the Fellowship position is $41,600 USD, with University Health System Benefits. The specific job description for this position will be included in the online application.