Hematology and Oncology Fellowship Curriculum

Goals and Objectives

LVHN’s Hematology and Oncology Fellowship program emphasizes education over service. The overall goal of LVHN’s Hematology and Oncology Fellowship program is to provide the education, training and clinical experience necessary to gain competence as a hematologist oncologist. This includes the goal of board certification in hematology and oncology by the American Board of Internal Medicine, competence in procedures typically expected of the hematology oncology subspecialist, and achievement of required performance skills through implementation of the ACGME Core Competencies.

Training Goals: Year 1

The first year of fellowship consists of intensive training in clinical hematology and oncology to develop the fundamental skills and knowledge required to become an outstanding clinician.

First-year fellows rotate on the following assignments:

• Hematology inpatient rotation

• • Fellows care for inpatients on the primary hematology service with a focus on leading rounds with attending supervision and writing all inpatient chemotherapy orders.
  • Fellows will do inpatient hematology consults.
• Oncology inpatient rotation
  • Fellows will do inpatient oncology consults.
    • Focus on initial plans at diagnosis
    • Focus on managing complications of chemotherapy
    • Focus on end-of-life issues
• Bone marrow transplant
  • Focus on indications for transplant
  • Focus on learning about different types of transplants and conditioning regimens
  • Focus on infectious disease and other complications of transplant
  • Focus on graft-versus-host disease
• Blood bank/pathology
  • Focus on laboratory techniques
  • Focus on peripheral smear and bone marrow biopsy interpretation
• Continuity clinic
  • Outpatient consultative hematology and oncology
• Research/scholarly activity
  • Research and independent study

Training Goals: Year 2

The second year of fellowship is designed to further prepare the fellow for a career in academic or private practice hematology/oncology by:

• Providing more extensive supervised experience in inpatient hematology and outpatient oncology
• Developing independence as a clinical hematologist oncologist
• Engaging in hematology oncology research and scholarly activity

The roles and responsibilities of the second-year hematology oncology fellow differ from those of the first-year fellows primarily in the level of independence and responsibility granted to the fellow. As fellowship progresses and fellows gain experience and competence, it is expected that the attendings allow the fellows to perform more autonomously with regard to medical decision-making, within the confines of the attending’s judgment of quality patient care. 

Second-year fellows rotate on the following assignments:

• Hematology/Oncology inpatient rotation
  • Fellows care for inpatients on the primary hematology service with a focus on leading rounds with attending supervision and writing all inpatient chemotherapy orders.
  • Fellows will do inpatient hematology consults.
• Oncology outpatient rotation
  • One-month focus on radiation oncology
  • One-month focus on gynecologic oncology
  • Three months in outpatient oncology office
    • Focus overall plan for chemotherapy
• Bone marrow transplant (optional rotation in second year, required in first year)
  • Focus on indications for transplant
  • Focus on learning about different types of transplants and conditioning regimens
  • Focus on infectious disease and other complications of transplant
  • Focus on graft-versus-host disease
• Continuity clinic
  • Outpatient consultative hematology oncology
• Palliative care
  • Focus on managing care at the end of life
• Research-scholarly activity
  • Research and independent study
• Radiation oncology
• Gynecology/oncology genetics

Training Goals: Year 3

• Outpatient oncology clinic-research.
• Fellows care for patients in the outpatient oncology clinic with a focus on common decisions about outpatient chemotherapy regimens, with supervision by an attending physician.
• During times when not directly caring for patients, fellows will work on a research project under the guidance of their mentor.

Curriculum: Call Schedule

First year: 10 weekends + 35 weeknights
Second year: 7 weekends + 25 weeknights
Third year: 10 weeknights (1 weekend covered by chief fellow)

• No in-house call
• Call room available if desired
• At-home pager call on weeknights, 5 p.m.-8 a.m.
• Weekend calls, 4 p.m. Friday-8 a.m. Monday
• Fellows round with in-house attending on Saturday and Sunday when on call

Conferences

The Hematology and Oncology Fellowship program provides multiple didactic and interactive conferences for information mastery. The conferences take a variety of formats, and their variety provides an interesting and diverse experience that complements the clinical experiences.

Lecture series includes topics such as:

• Malignant hematology
• Benign hematology
• Pharmacology
• Oncology
• Genetics
• Hereditary breast and ovarian cancer
• Colon cancer syndromes
• Principles of radiation oncology
• Subspecialty tumor boards