Teaching of Hematology

The teaching of Hematology has largely been integrated with the teaching and training in Oncology and there has been no attempt to isolate the two disciplines.  Fellows are encouraged during their training to use elective time to pursue specific rotations in the hematologic field. The Blood Bank, under the direction of Dr. Gregory Pomper, has established a fellowship rotation which exposes individuals to all facets of blood banking and immunohematology.  Similar rotations are available through hematology laboratory and the coagulation laboratory.  Dr. John Owen is the Director of the Coagulation Laboratory and is the Associate Director of the Hematology Laboratory.

The major forum for teaching in this area is a weekly case based Hematology Conference which is led by Dr. Owen.  The principle intent of this conference is to expose fellows to the rational and logical application of hematologic knowledge.  Each meeting typically begins with an evaluation of a blood smear together with minimal clinical information.  Information, constructs, and hypotheses are then generated based upon this, and they are tested against the reality which is usually known for that specific patient.  The content of this conference runs the gamut from direct patient care through all levels of basic science.  This conference has been particularly well received by the fellows and has in the large part been responsible for the growing interest in non­malignant hematology amongst our fellowship candidates.

Teaching of Oncology

The subspecialty program in Oncology is organized to provide training and experience over three years that will allow the trainee to become a competent oncologist.  Clinical experience consists of observation and management of patients with a variety of oncologic problems including both solid tumors and hematologic malignancies.  The clinical experience is accomplished in both the inpatient and outpatient settings. Minimum experiences include inpatient rotations in solid tumor, leukemia, bone marrow transplantation, and consults.  Outpatient rotations include the Hematology and Oncology outpatient clinic and the continuity clinic.

The joint Hematology and Oncology Fellowship program is "front loaded" with clinical experience in Oncology, as a result, under ABIM rules, individuals who have joined a three year program leading to dual eligibility may elect to curtail their program after two years and sit for Board Certification in Medical Oncology.

Minimum experiences include inpatient rotations in solid tumor, leukemia, bone marrow transplantation, and consults.  Outpatient rotations include the Hematology and Oncology outpatient clinic and the fellows' clinic.  The following selective areas, approved by the Fellowship Committee, provide for 6 months of additional rotations:

  

Radiation Oncology	Laboratory Coagulation
Pediatric Oncology	Pain Control
Gynecologic Oncology	Research
Laboratory Basics	Blood Transfusion
Additional Clinical Rotations	Hematopathology

 

The trainee is given the opportunity to assume continuing responsibility for acute and chronically ill patients by following their own patients in the fellows clinic, by seeing unscheduled patients in the outpatient clinic, and by seeing new patients and acutely ill patients in the emergency room during on-call duty.

An attending physician is assigned for supervision and is available at all times to serve as a resource to the fellow.  This includes a clinic supervisor, an attending supervisor for all inpatient and consult services, and an attending on call to discuss and see new and acutely ill patients.

Research

All Fellows spend at least three months doing laboratory research. The purpose is to ensure that all Fellows have a basis for making career choices. This mandated rotation occurs in year one and can form the basis for an ongoing involvement in "wet" research during the whole of the fellowship. Taking a leadership role in other research areas, particularly clinical trials, is strongly encouraged. As a member of the Section, fellows are expected to support the research efforts of all Section members.

Vacation and Statutory Holidays

Each fellow is allowed 3 weeks vacation to be taken at the fellow’s convenience, subject to certain limitations. The limitations derive from professional responsibility and all absences require adequate and approved coverage for responsibilities. It is recognized that under certain circumstances this may not be possible, in which case the request will be considered on its merits.  Requests for vacation must be submitted in writing to the Program Director as early as possible.  The request for vacation must include a vacation form detailing the cross coverage for the fellow’s responsibilities. Cross-covering fellows or faculty must signify their acceptance of these responsibilities by their signature.

Fellows in their last year in the institution are required to be on site during the last two weeks of June of their final year.

Additionally, each fellow will have five consecutive days off to coincide with either the Christmas or New Year Holiday. (Four days in addition to either the Christmas or New year Holiday)

Statutory holidays will be taken in accordance with the general practice of the institution.  Coverage of service functions will be arranged as for weekend coverage.

Academic Requirements

Formal Conferences: (Attendance of all fellows is required)

• Internal Medicine Grand Rounds, Thursday 7:45-9:00 a.m.
  All fellows are expected to attend Internal Medicine Grand Rounds.
  
• Fellows Core Conferences - To be held daily noon to 1 p.m.
  
  • Monday: Oncology Core Curriculum
  • Tuesday: Hematology Case Conference
  • Wednesday: Hematopathology alternating with Bone Marrow slide conference
  • Thursday: BLOOD Review alternating with TBA topics
  • Friday: Surgical Oncology / Tumor Board conference
    
• Fellows are expected to attend the Research Protocol Meeting the last Tuesday of every month at 5:00 pm. Fellows are expected to be primary reviewer and presenter at protocol meeting as assigned.

Teaching Conferences

Fellows on outpatient/teaching rotation will be responsible for scheduling and supervising housestaff and student conference to be held at least once weekly. Scheduled topic should be posted and each team should be informed and expected to attend.

Reading

Fellows should read each issue of Blood and The Journal of Clinical Oncology. They are also expected to read one of the standard textbooks of Hematology and one textbook of Oncology.

Attendance at Scientific Meetings

Attending and participating in scientific meetings is an important part of training. A limited amount of money is available to cover expenses. Any fellow is free to attend any meeting of his choice on his own time and at his own expense provided all service responsibilities have been covered. The Hematology and Oncology Section provides $1,000 per year to offset the cost of attending meetings. In general, Fellows are expected to share a hotel room and use the lowest reasonable advance purchase air-fare. Should a fellow choose not to share a room, then the reimbursement would still be limited to the amount paid if a room was shared.

First year Fellows are expected to attend the American Society of Clinical Oncology Meeting (May) and second year Fellows the American Society of Hematology (December). Third year Fellows in a joint Hematology and Oncology program are expected to attend both the ASH and ASCO meetings. Reimbursement for attendance at any other meeting will be at the discretion of the Program Director.

Local Meetings

All fellows are expected to attend the meetings of the Piedmont Oncology Association. The fellow on call for that day will remain at WFUBMC until the end of the working day in order to be available for phone calls, emergency consults and back-up for oncology housestaff.

Fall POA Symposium. All fellows are encouraged to attend with expenses to be covered by the Section. As for National Meetings, reimbursement will be based on shared accomodation and shared ground transportation.