- 5 months inpatient/consultative Hematology
- 4months inpatient/consultative Oncology
- 1 month Radiation Oncology
- 1 month Palliative Care
- 1 month Blood Bank rotation
- 2 months inpatient stem cell transplantation, National Heart, Lung and Blood Institute
- 2 months inpatient/consultative hematology at MedStar Georgetown University Hospital
- 1 month Lab/Pathology rotation
- 2 months inpatient/consultative oncology, MedStar Washington Hospital Center
- 1 month inpatient/consultative hematology, MedStar Washington Hospital Center
- 4 months research
- 1-2 months inpatient/consultative oncology, MedStar Washington Hospital Center
- 1-2 months inpatient/consultative hematology, MedStar Washington Hospital Center
- 1 month consultative hematology, National Heart, Lung and Blood Institute
- 1 month Gynecologic oncology
- 6 months research
All clinical rotations, unless otherwise noted, take place at the Hospital Center.
Prior to each rotation, the fellows are given a syllabus and introduction to the rotation,which outlines the expectations and educational goals. Evaluations are done at the end of each rotation. Fellows are also given the opportunity to evaluate rotations and faculty. Fellows are assigned a mentor for their three years of training. Fellows are required to take the ASH and ASCO inservice examinations in the second and third years, which is important for self-evaluation of the fellows’ Hem/Onc knowledge.
First-year fellows have two half-days of continuity clinic per week. Both continuity clinics are continued in the second and third year, and fellows also rotate through a one half-day subspecialty clinic for a six-month duration each, during these years. For continuity and long-term patient follow-up experience, we assign fellows responsibility for following patients in their continuity clinics during the entire time they are in training.
Four months (2nd year), Six months (3rd year)
Fellows are exposed to clinical research through topical presentations at the monthly Basic Science and Research conference, as well as the Friday Cancer Conference. They have lectures on clinical research methods and statistics, and are required to present new clinical research protocols at the monthly Scientific Review Committee Meeting.
The fellows have exposure and can collaborate and conduct research projects not only with the Hospital Center faculty, but also MedStar Georgetown University Hospital/Lombardi Cancer Center and National Heart, Lung and Blood Institute faculty.
Supervisory and patient care responsibilities
Hem/Onc fellows are responsible for supervising internal medicine residents and medical students who are caring for inpatients on the Hematology/Oncology unit and other floors. In addition, they participate in the supervision and teaching of internal medicine residents and students on the Hematology and Medical Oncology elective rotations, and serve as an initial resource of information.
The Hem/Onc fellows interact with internal medicine, other subspecialty and specialty residents both on inpatient/consultant rounds, and in the ambulatory setting in the Hematology and Medical Oncology clinics. Several hours per week are devoted to sit-down review sessions for the medical residents and students on the elective; the Hem/Onc fellow is responsible for participating in one to two of these sessions per week.
Several multidisciplinary oncology conferences are held regularly and fellows often present cases and are encouraged to participate in management discussions. Fellows on service are required to do presentations at weekly hematology and oncology patient management conferences while on their inpatient rotations.
The trainee should have:
- Knowledge about the care and use of indwelling venous devices.
- Knowledge about the acute toxicities of chemotherapy related to administration of drugs.
- Knowledge about the administration of chemotherapy and biologics by all therapeutic routes.
- Knowledge about the handling and disposal of chemotherapeutic and biologic agents.
Bone marrow aspiration, biopsy, and interpretation
- Trainees must demonstrate an ability to perform a bone marrow aspiration and biopsy.
- They should have experience in the interpretation of marrow aspirations and biopsies, peripheral blood smears and lymph node biopsies.
Ommaya reservoir and lumbar puncture
- Trainees must demonstrate an ability to perform a lumbar puncture and to administer chemotherapy by that route.
- Trainees must be capable of accessing and administering chemotherapy through an Ommaya reservoir.